Healthcare Provider Details

I. General information

NPI: 1285551515
Provider Name (Legal Business Name): ANDRES FELIPE HERRERA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12777 FOREST HILL BLVD STE 1502
WELLINGTON FL
33414-4775
US

IV. Provider business mailing address

12777 FOREST HILL BLVD STE 1502
WELLINGTON FL
33414-4775
US

V. Phone/Fax

Practice location:
  • Phone: 561-299-4112
  • Fax:
Mailing address:
  • Phone: 561-299-4112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH27507
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: