Provider Demographics
NPI:1700552544
Name:LERMA, INGRID
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:LERMA
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 1:13014 N DALE MABRY HWY STE 659
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2808
Mailing Address - Country:US
Mailing Address - Phone:813-215-6275
Mailing Address - Fax:866-636-0443
Practice Address - Street 1:13014 N DALE MABRY HWY STE 659
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2808
Practice Address - Country:US
Practice Address - Phone:813-215-6275
Practice Address - Fax:866-636-0443
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant