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General NPI Number Information
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NPI Number | 1992885495
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Entity Type | Organization
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Legal Business Name | JANICE M HERBERT MD PA
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 1012 NEBRASKA AVE
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City | PALM HARBOR
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State | FL
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Zip | 34683
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Country | US
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Telephone | 727-786-0850
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 76074
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City | ST PETERSBURG
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State | FL
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Zip | 33734-6074
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Country | US
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Telephone | 727-786-0850
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANICE MARIE HERBERT
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Credential | MD
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Telephone | 727-786-0850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 800010180
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License Number State | FL
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