Healthcare Provider Details

I. General information

NPI: 1487264057
Provider Name (Legal Business Name): ANOUK HERRERA P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 GIRALDA AVE APT 507W
CORAL GABLES FL
33134-5063
US

IV. Provider business mailing address

2930 SW 107TH AVE
MIAMI FL
33165-2433
US

V. Phone/Fax

Practice location:
  • Phone: 786-277-2938
  • Fax:
Mailing address:
  • Phone: 786-277-2938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ANOUK HERRERA
Title or Position: LCSW
Credential:
Phone: 786-277-2938