MEDICARE: ERIC HERRIN 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	213E00000X	Podiatrist	PO 2855	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01512695	OTHER	WI	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1427388081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC HERRIN DPM

Provider Business Mailing Address
First Line	:	112 N 12TH ST
Second Line	:	1909
City	:	TAMPA
State	:	FL
Zip	:	33602-3764
Country	:	US
Telephone Number	:	713-253-6554
Fax Number	:

Provider Business Practice Location Address
First Line	:	13600 ICOT BLVD
Second Line	:	BLDG B
City	:	CLEARWATER
State	:	FL
Zip	:	33760-3703
Country	:	US
Telephone Number	:	727-796-6900
Fax Number	:

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

Provider Enumeration Date	:	01/05/2010
Last Update Date	:	11/29/2016

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Directions to “ ERIC HERRIN DPM” Practice Location

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