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Individual

MRS. CAROLINE ALICIA HERAMB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
5505 PEACHTREE DUNWOODY RD STE 600, ATLANTA, GA 30342
(404) 355-0743
(855) 286-3226
Mailing address
5505 PEACHTREE DUNWOODY RD STE 600, ATLANTA, GA 30342-1717
(404) 355-0743
(855) 286-3226

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA9107781
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9107781
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010495200
FL
Enumeration date
01/29/2014
Last updated
06/12/2018
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