Healthcare Provider Details
I. General information
NPI: 1659998482
Provider Name (Legal Business Name): DON HERSHELSON NOEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/27/2020
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4330 SHERIDAN ST STE 102B
HOLLYWOOD FL
33021-1407
US
IV. Provider business mailing address
17015 MIDAS LN
LUTZ FL
33549-7600
US
V. Phone/Fax
- Phone: 954-287-2010
- Fax: 305-723-1910
- Phone: 561-373-3207
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207WX0107X |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| License Number | ME169387 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: