MEDICARE: JOSE D HERRERA

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	171WV0202X	Vehicle Modifications Contractor

General Provider Information

NPI Number	:	1962855916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE D HERRERA

Provider Business Mailing Address
First Line	:	3158 CEDAR GROVE DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-1708
Country	:	US
Telephone Number	:	703-899-9918
Fax Number	:	703-281-3203

Provider Business Practice Location Address
First Line	:	3158 CEDAR GROVE DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-1708
Country	:	US
Telephone Number	:	703-899-9918
Fax Number	:	703-281-3203

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

Provider Enumeration Date	:	07/14/2016
Last Update Date	:	07/14/2017

Similar Medicare Providers

1063934545 — ROJHALEX ENTERPRISER LLC
Practice Location Address:

3158 CEDAR GROVE DR
FAIRFAX, VA
22031-1708

Practice Phone: 703-899-9918
Practice Fax: 703-563-6096

1043047855 — RAYMOND LU DNP
Practice Location Address:

3154 CEDAR GROVE DR
FAIRFAX, VA
22031-1708

Practice Phone: 954-465-4962
Practice Fax:

1194433680 — MARTIN ELSASS
Practice Location Address:

1708 COLUMBIANA LISBON RD
COLUMBIANA, OH
44408-9441

Practice Phone: 330-272-8574
Practice Fax:

1487011532 — YSABEL PELAEZ CRNA
Practice Location Address:

8225 ADENLEE AVE , APT 10
FAIRFAX, VA
22031-4825

Practice Phone: 571-242-2798
Practice Fax:

1164375580 — SOPHIA BETTGER
Practice Location Address:

2721 PROSPERITY AVE STE 100
FAIRFAX, VA
22031-4341

Practice Phone: 240-342-2666
Practice Fax:

1790638112 — EMILY OLIVON
Practice Location Address:

2721 PROSPERITY AVE STE 100
FAIRFAX, VA
22031-4341

Practice Phone: 240-342-2666
Practice Fax:

Directions to “ JOSE D HERRERA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.