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Individual

MRS. BETTY ANN HERRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OWNER OPERATOR

Contact information

Practice address
7200 SAN MIGUEL DR, PORT RICHEY, FL 34668-5031
(727) 848-3468
(727) 842-6401
Mailing address
7200 SAN MIGUEL DR, PORT RICHEY, FL 34668-5031
(727) 848-3468
(727) 842-6401

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
332B00000X
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
332B00000X
CNT
FL
Enumeration date
06/17/2008
Last updated
06/17/2008
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