MEDICARE: MARTHA G HERRERA DPM

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	PO3568	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	:	1285984104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA G HERRERA DPM

Provider Business Mailing Address
First Line	:	8613 OLD KINGS RD S STE 301
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4845
Country	:	US
Telephone Number	:	904-802-5921
Fax Number	:	904-423-1382

Provider Business Practice Location Address
First Line	:	8613 OLD KINGS RD S STE 301
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4845
Country	:	US
Telephone Number	:	904-802-5921
Fax Number	:	904-437-1532

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

Provider Enumeration Date	:	09/18/2012
Last Update Date	:	09/08/2025

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