Provider Demographics
NPI:1306911706
Name:HERY, ADRIENNE LAWTON (MD)
Entity type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:LAWTON
Last Name:HERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:LAWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 WEBBER ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5237
Mailing Address - Country:US
Mailing Address - Phone:941-362-8900
Mailing Address - Fax:
Practice Address - Street 1:2001 WEBBER ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-362-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103571207ZD0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IUBX9OtherBLUE CROSS BLUE SHIELD
FL017870200Medicaid
FLIUBX9OtherBLUE CROSS BLUE SHIELD
FL017870200Medicaid