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NPI Code Detail

MEDICARE: PETER K HERVIE M.D.

MEDICARE: PETER K HERVIE M.D.
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
1208000000XPediatrics PhysicianME110130FL
22080P0203XPediatric Critical Care Medicine Physician347382LA
3208000000XPediatrics Physician234619MA
42080P0203XPediatric Critical Care Medicine PhysicianME110130FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225200116
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER K HERVIE M.D.
Provider Business Mailing Address
First Line : 5924 AUVER BLVD APT 104
Second Line :
City : ORLANDO
State : FL
Zip : 32807-3785
Country : US
Telephone Number : 201-696-5881
Fax Number :
Provider Business Practice Location Address
First Line : 844 N THORNTON AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32803-4003
Country : US
Telephone Number : 407-894-8768
Fax Number : 407-894-6872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2008
Last Update Date : 06/01/2026

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