MEDICARE: LUDIM E HERRERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	363LF0000X	Family Nurse Practitioner	9268132	FL
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9268132	FL

General Provider Information

NPI Number	:	1013493972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUDIM E HERRERA

Provider Business Mailing Address
First Line	:	3152 SW 17TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-1802
Country	:	US
Telephone Number	:	786-378-0358
Fax Number	:

Provider Business Practice Location Address
First Line	:	2103 CORAL WAY STE 603
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2656
Country	:	US
Telephone Number	:	786-464-0353
Fax Number	:	786-483-8142

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2018
Last Update Date	:	04/11/2024

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Directions to “ LUDIM E HERRERA ” Practice Location

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