MEDICARE: GLEN A. HERMAN MD

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	207L00000X	Anesthesiology Physician	ME56248	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	298805	OTHER	FL	AVMED
2	12808	OTHER	FL	BCBS OF FLORIDA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114906674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLEN A. HERMAN MD

Provider Business Mailing Address
First Line	:	600 NE 20TH LN
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-2401
Country	:	US
Telephone Number	:	561-542-1553
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 NE 20TH LN
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-2401
Country	:	US
Telephone Number	:	561-542-1553
Fax Number	:

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

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	02/10/2025

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Directions to “ GLEN A. HERMAN MD” Practice Location

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