MEDICARE: DAVID M HERSON 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	208VP0000X	Pain Medicine Physician	ME61297	FL
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME61297	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	720000186	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2593507	OTHER	FL	CIGNA
2	4565372	OTHER	FL	AETNA
4	58760	OTHER	FL	BCBS OF FL
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	279800	OTHER	FL	AVMED

General Provider Information

NPI Number	:	1316942030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M HERSON MD

Provider Business Mailing Address
First Line	:	14701 CROYDON PL
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2160
Country	:	US
Telephone Number	:	813-443-5817
Fax Number	:	813-443-5818

Provider Business Practice Location Address
First Line	:	21756 STATE ROAD 54
Second Line	:	SUITE 102A
City	:	LUTZ
State	:	FL
Zip	:	33549-2905
Country	:	US
Telephone Number	:	813-443-5817
Fax Number	:	813-443-5818

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	08/24/2009

Similar Medicare Providers

1417945130 — DR. GEORGE R COMPANIONI M.D.
Practice Location Address:

21756 STATE ROAD 54 STE 102A
LUTZ, FL
33549-2905

Practice Phone: 813-977-4767
Practice Fax: 813-977-6275

1972697944 — TAMPA ORTHOPEDIC CLINIC,LLP
Practice Location Address:

21756 STATE ROAD 54 STE 102A
LUTZ, FL
33549-2905

Practice Phone: 813-977-4767
Practice Fax: 813-977-6275

1720115405 — MR. WILLIAM SHANNON MERRICK PT, ATC
Practice Location Address:

21756 STATE ROAD 54 , STE 102
LUTZ, FL
33549-2905

Practice Phone: 813-279-6234
Practice Fax: 813-949-1927

1215051776 — BETH ANN PATTERSON PT
Practice Location Address:

21756 STATE ROAD 54 STE 102
LUTZ, FL
33549-2905

Practice Phone: 727-475-5540
Practice Fax: 844-213-8986

1144412362 — MR. MATTHEW RYAN SMITH PA-C
Practice Location Address:

21756 STATE ROAD 54 STE 102A
LUTZ, FL
33549-2905

Practice Phone: 813-493-4093
Practice Fax: 656-444-7252

1356573489 — DAVID HERSON MD PA
Practice Location Address:

21756 STATE ROAD 54 , SUITE 102A
LUTZ, FL
33549-2905

Practice Phone: 813-443-5817
Practice Fax: 813-443-5818

Directions to “ DAVID M HERSON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.