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NPI Code Detail

MEDICARE: DR. HERMAN L DEANNA OD

MEDICARE: DR. HERMAN L DEANNA OD
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
1152W00000XOptometristOPC2749FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25723570OTHERFLAETNA PIN
3810468OTHERFLEYEMED PIN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245204502
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HERMAN L DEANNA OD
Provider Business Mailing Address
First Line : 7100 W 20TH AVE STE 702
Second Line :
City : HIALEAH
State : FL
Zip : 33016-1824
Country : US
Telephone Number : 305-825-3005
Fax Number : 305-819-5887
Provider Business Practice Location Address
First Line : 7100 W 20TH AVE STE 702
Second Line :
City : HIALEAH
State : FL
Zip : 33016-1824
Country : US
Telephone Number : 305-825-3005
Fax Number : 305-819-5887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 01/21/2024

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Directions to “ DR. HERMAN L DEANNA OD” Practice Location

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