Provider Demographics
NPI:1528605235
Name:HERPIN, ANNA M (CMBC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:HERPIN
Suffix:
Gender:F
Credentials:CMBC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIA
Other - Last Name:HERPIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:154 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2143
Mailing Address - Country:US
Mailing Address - Phone:407-619-5071
Mailing Address - Fax:
Practice Address - Street 1:154 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2143
Practice Address - Country:US
Practice Address - Phone:407-619-5071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-02
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3059305S00000X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No305S00000XManaged Care OrganizationsPoint of Service