MEDICARE: ALYSA ROBIN HERMAN MD

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	207ND0101X	MOHS-Micrographic Surgery Physician	ME89408	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	:	1245235829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSA ROBIN HERMAN MD

Provider Business Mailing Address
First Line	:	135 SAN LORENZO AVENUE
Second Line	:	S.700
City	:	CORAL GABLES
State	:	FL
Zip	:	33146
Country	:	US
Telephone Number	:	305-444-4979
Fax Number	:	305-444-4978

Provider Business Practice Location Address
First Line	:	135 SAN LORENZO AVENUE
Second Line	:	S.700
City	:	CORAL GABLES
State	:	FL
Zip	:	33146
Country	:	US
Telephone Number	:	305-444-4979
Fax Number	:	305-444-4978

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	06/17/2013

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