Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME76081 | FL |
NPI | 1083691257 |
---|---|
Provider Name | Mercedes T Pernice |
First Address | Gainesville, FL 32605-4582 |
Second Address | Gainesville, FL 32607-2817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 09/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
263496100 | (05) | FL |
F69272 | (02) | FL |