Provider Demographics
NPI:1427015684
Name:HERMANS, PATRICIA (PA)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:HERMANS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 S BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2630
Mailing Address - Country:US
Mailing Address - Phone:813-254-3016
Mailing Address - Fax:813-254-3019
Practice Address - Street 1:4051 UPPER CREEK DR STE 108
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-6825
Practice Address - Country:US
Practice Address - Phone:813-634-9264
Practice Address - Fax:813-634-8578
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102353363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP016113364OtherMEDICARE RALIROAD
FLU0545UMedicare PIN
FLP00445733OtherMEDICARE RAILROAD