Lera Liv Fina, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS 10686 Issued in FL

Practice address

22455 Flora Parke Xing
Fernandina Beach, FL 32034-8000

Phone

(904) 572-1884

NPI assigned

Apr 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Lera Liv Wullenweber Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17308/brand/1/csg/1/fhir/r4
• Direct secure messaging: lera.fina.1@17308.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Flip Flops and Lollipops Pediatrics

  • Primary Care Clinic/Center
  • Fernandina Beach, FL
  • NPI 1013443423
  NPD (past) Authorized official

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1902079635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22455 FLORA PARKE XING",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320348000",
            "telephone_number": "904-572-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22455 FLORA PARKE XING",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320348000",
            "telephone_number": "904-572-1884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 Dan Proctor Dr",
            "address_2": "suite 140",
            "address_purpose": "LOCATION",
            "city": "Saint Marys",
            "state": "GA",
            "postal_code": "315583811",
            "country_code": "US",
            "telephone_number": "912-673-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "96279 Brady Point RD STE C",
            "address_purpose": "LOCATION",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "32034",
            "country_code": "US",
            "telephone_number": "904-572-1884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FINA",
        "first_name": "LERA",
        "middle_name": "LIV",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "66488",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS 10686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202IO12485",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LERA",
            "last_name": "WULLENWEBER",
            "middle_name": "LIV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mishonda T Felix, APRN
• Fernandina Beach Rehab, LLC (Fernandina Beach Rehabilitation and Nursing Center)
• Stephanie Ferrer, PSY.D.
• Paul Bradley Ferris, PHARM. D.
• Abigail Carter Fields, IMH
• Leanne Finnie
• First Coast Counseling
• First Coast Pediatrics
• Flip Flops and Lollipops Pediatrics
• Barbara Flor, ED.S., LPC, NCC

• Pediatrics Physician in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.