Provider Demographics
NPI:1427427160
Name:HERRERA, ANA M
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:M
Last Name:HERRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 SW 75TH ST APT 204
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-1854
Mailing Address - Country:US
Mailing Address - Phone:239-272-0825
Mailing Address - Fax:
Practice Address - Street 1:715 SW 75TH ST APT 204
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-1854
Practice Address - Country:US
Practice Address - Phone:239-272-0825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3625291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory