Individual provider Active NPI

Lauren Wittmann Herraiz, NP-C

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1073938650
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9318400 Issued in FL
Practice address
4004 N Riverside Dr
Tampa, FL 33603-3212
Phone
(813) 279-6900
NPI assigned
Feb 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9318400 FL Primary

Addresses

Primary practice location

4004 N Riverside Dr
Tampa, FL 33603-3212

Mailing address

10631 Bardes CT
Seminole, FL 33777-1222
Phone (727) 470-3254

Other practice location 1

4730 N Habana Ave Ste 206
Tampa, FL 33614-7148
Phone (954) 231-3080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9318400FLMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1073938650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10631 BARDES CT",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337771222",
            "telephone_number": "727-470-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 N RIVERSIDE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033212",
            "telephone_number": "813-279-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4730 N Habana Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336147148",
            "country_code": "US",
            "telephone_number": "954-231-3080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRAIZ",
        "first_name": "LAUREN",
        "middle_name": "WITTMANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9318400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.