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General NPI Number Information
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NPI Number | 1467640672
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Entity Type | Organization
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Legal Business Name | RONALD JOHN HEROMIN M.D.,P.A.
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 779 MEDICAL DR STE 7
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City | ENGLEWOOD
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State | FL
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Zip | 34223-3980
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Country | US
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Telephone | 941-475-5626
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Fax | 941-475-5627
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Provider Business Mailing Address
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Address Line | 779 MEDICAL DR STE 7
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City | ENGLEWOOD
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State | FL
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Zip | 34223-3980
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Country | US
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Telephone | 941-475-5626
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Fax | 941-475-5627
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD JOHN HEROMIN
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Credential | M.D.
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Telephone | 941-475-5626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME47301
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License Number State | FL
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