Individual
EDUVIGIA ANCAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1611 STATE ROAD 60 E, LAKE WALES, FL 33853-4309
(863) 676-6007
(863) 676-7659
Mailing address
1611 STATE ROAD 60 E, LAKE WALES, FL 33853-4309
(863) 676-6007
(863) 676-7659
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME15606
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3386725
CIGNA
FL
01
—
53403
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
05/27/2006
Last updated
05/18/2011
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