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General NPI Number Information
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NPI Number | 1649597485
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Entity Type | Organization
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Legal Business Name | RAUL J HERRADA MD PA
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 06/04/2010
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Provider Practice Location Address
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Address Line | 2177 E MICHIGAN ST SUITE 1
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City | ORLANDO
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State | FL
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Zip | 32806-4948
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Country | US
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Telephone | 407-896-4147
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Fax | 407-895-7182
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Provider Business Mailing Address
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Address Line | 2177 EAST MICHIGAN STREET SUITE 1
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City | ORLANDO
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State | FL
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Zip | 32806-4948
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Country | US
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Telephone | 407-896-4147
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Fax | 407-895-7182
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LEISY H GONZALEZ
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Credential |
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Telephone | 407-896-4147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME0026137
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License Number State | FL
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