MEDICARE: DR. MICHAEL DAVID HERBERT 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	9226	FL

General Provider Information

NPI Number	:	1740347418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DAVID HERBERT DDS

Provider Business Mailing Address
First Line	:	6032 PARADISE POINT DR
Second Line	:
City	:	VILLAGE OF PALMETTO BAY
State	:	FL
Zip	:	33157-2634
Country	:	US
Telephone Number	:	305-254-6928
Fax Number	:	305-271-3013

Provider Business Practice Location Address
First Line	:	12515 SW 88TH ST
Second Line	:	SUITE 130
City	:	MIAMI
State	:	FL
Zip	:	33186-1870
Country	:	US
Telephone Number	:	305-271-9711
Fax Number	:	305-271-3013

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

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/08/2007

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