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General NPI Number Information
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NPI Number | 1538504972
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Entity Type | Organization
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Legal Business Name | EDWIN HERRERA MD PA
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 431 SW 87TH CT
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City | MIAMI
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State | FL
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Zip | 33174-2433
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Country | US
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Telephone | 305-978-1486
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Fax | 786-618-9583
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Provider Business Mailing Address
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Address Line | 431 S.W. 87 COURT
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City | MIAMI
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State | FL
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Zip | 33174
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Country | US
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Telephone | 305-978-1486
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Fax | 786-618-9583
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | EDWIN HERRERA
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Credential | MD
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Telephone | 305-978-1486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME72391
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License Number State | FL
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