MEDICARE: DR. VICTORIA E HERRERA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN18302	FL

General Provider Information

NPI Number	:	1114185550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTORIA E HERRERA DDS

Provider Business Mailing Address
First Line	:	2360 SW 19TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2432
Country	:	US
Telephone Number	:	305-244-1722
Fax Number	:

Provider Business Practice Location Address
First Line	:	2375 SW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3641
Country	:	US
Telephone Number	:	305-856-2300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2008
Last Update Date	:	05/31/2008

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