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General NPI Number Information
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NPI Number | 1093080699
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Entity Type | Individual
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Provider Name | ADRIANA HERRERA PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 220 SW 84TH AVE SUITE 105
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City | PLANTATION
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State | FL
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Zip | 33324-2754
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Country | US
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Telephone | 954-473-2011
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Fax | 954-473-8611
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Provider Business Mailing Address
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Address Line | 220 SW 84TH AVE SUITE 105
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City | PLANTATION
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State | FL
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Zip | 33324-2754
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Country | US
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Telephone | 954-473-2011
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Fax | 954-473-8611
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9106399
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License Number State | FL
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