Healthcare Provider Details

I. General information

NPI: 1124077003
Provider Name (Legal Business Name): LUIS FERNANDO HERRERA -BEHR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LUIS FERNANDO HERRERA BEHR MD

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4584 COMMERCIAL WAY
SPRING HILL FL
34606-1919
US

IV. Provider business mailing address

4584 COMMERCIAL WAY
SPRING HILL FL
34606-1919
US

V. Phone/Fax

Practice location:
  • Phone: 352-592-1191
  • Fax: 352-592-1191
Mailing address:
  • Phone: 352-592-1191
  • Fax: 352-592-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME82355
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: