Healthcare Provider Details

I. General information

NPI: 1083766877
Provider Name (Legal Business Name): PABLO HERSCOVICI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3476 S UNIVERSITY DR
DAVIE FL
33328-2000
US

IV. Provider business mailing address

3702 NE 199TH ST
AVENTURA FL
33180-3056
US

V. Phone/Fax

Practice location:
  • Phone: 954-475-4400
  • Fax:
Mailing address:
  • Phone: 917-446-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME112073
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME112073
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: