MEDICARE: DR. VICTOR LUIS HERRERA D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	POD-001096	AZ
2	213ES0103X	Foot & Ankle Surgery Podiatrist	PO 3517	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043594062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR LUIS HERRERA D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 649
Second Line	:
City	:	FORT DEFIANCE
State	:	AZ
Zip	:	86504-0649
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	CORNER OF RT N12 & N7
Second Line	:
City	:	FORT DEFIANCE
State	:	AZ
Zip	:	86504-0649
Country	:	US
Telephone Number	:	928-729-8000
Fax Number	:

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

Provider Enumeration Date	:	10/10/2011
Last Update Date	:	03/11/2026

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