Healthcare Provider Details

I. General information

NPI: 1205079324
Provider Name (Legal Business Name): NIURKA HERRERA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 W FLAGLER ST
MIAMI FL
33174-4210
US

IV. Provider business mailing address

1400 NW 107TH AVE STE 500
SWEETWATER FL
33172-2746
US

V. Phone/Fax

Practice location:
  • Phone: 305-534-0076
  • Fax: 305-649-6071
Mailing address:
  • Phone: 305-534-0076
  • Fax: 305-631-2806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3436
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO3436
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: