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General NPI Number Information
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NPI Number | 1699251389
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Entity Type | Individual
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Provider Name | JEFFREY HERRERA LAC
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Gender | Male
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 07/16/2018
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Provider Practice Location Address
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Address Line | 200 N DENNING DR STE 7
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City | WINTER PARK
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State | FL
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Zip | 32789-3736
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Country | US
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Telephone | 407-900-7145
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Fax |
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Provider Business Mailing Address
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Address Line | 2435 PEAR TREE CT
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City | ORLANDO
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State | FL
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Zip | 32807-6460
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Country | US
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Telephone | 407-257-0948
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP3150
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License Number State | FL
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