Individual
MARIA GIERON-KORTHALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4742
(813) 259-8717
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME37495
FL
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
ME37495
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065319500
—
FL
01
—
30340
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/05/2006
Last updated
10/27/2020
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