Provider Demographics
NPI:1518986629
Name:HERMANN, ANNE C (MD)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:C
Last Name:HERMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 W CYPRESS ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1615
Mailing Address - Country:US
Mailing Address - Phone:813-902-9559
Mailing Address - Fax:813-315-6611
Practice Address - Street 1:3040 W CYPRESS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1615
Practice Address - Country:US
Practice Address - Phone:813-902-9559
Practice Address - Fax:813-315-6611
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2129YMedicare ID - Type Unspecified
I02035Medicare UPIN
FLK9639Medicare ID - Type Unspecified