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NPI Code Detail

MEDICARE: MRS. LAUREN WITTMANN HERRAIZ NP-C

MEDICARE: MRS. LAUREN WITTMANN HERRAIZ NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner9318400FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073938650
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAUREN WITTMANN HERRAIZ NP-C
Provider Business Mailing Address
First Line : 10631 BARDES CT
Second Line :
City : SEMINOLE
State : FL
Zip : 33777-1222
Country : US
Telephone Number : 727-470-3254
Fax Number :
Provider Business Practice Location Address
First Line : 4004 N RIVERSIDE DR
Second Line :
City : TAMPA
State : FL
Zip : 33603-3212
Country : US
Telephone Number : 813-279-6900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2014
Last Update Date : 01/18/2022

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