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General NPI Number Information
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NPI Number | 1174566483
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Entity Type | Individual
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Provider Name | DAVID H HERSCHTHAL MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 7280 W PALMETTO PARK RD STE 210
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City | BOCA RATON
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State | FL
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Zip | 33433-3412
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Country | US
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Telephone | 613-919-2005
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Fax | 613-385-7027
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Provider Business Mailing Address
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Address Line | 7421 NORTH UNIVERSITY DR STE 301
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City | TAMARAC
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State | FL
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Zip | 33321
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Country | US
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Telephone | 954-722-3900
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Fax | 954-720-9720
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME31531
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License Number State | FL
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