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NPI Code Detail

MEDICARE: MRS. MERCEDES LILIANA HIGGINS

MEDICARE:  MRS. MERCEDES LILIANA HIGGINS
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
1124Q00000XDental HygienistDH17120FL

General Provider Information

NPI Number : 1902932601
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MERCEDES LILIANA HIGGINS
Provider Business Mailing Address
First Line : 2308 EVEREST PKWY
Second Line :
City : CAPE CORAL
State : FL
Zip : 33904-3352
Country : US
Telephone Number : 239-242-2533
Fax Number :
Provider Business Practice Location Address
First Line : 15650 SAN CARLOS BLVD
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-2569
Country : US
Telephone Number : 239-489-1118
Fax Number : 239-489-3627
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. MERCEDES LILIANA HIGGINS ” Practice Location

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