MEDICARE: MR. PAUL J HERSCH 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	207R00000X	Internal Medicine Physician	ME0014485	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	245925	OTHER	FL	AVMED
2	5883296	OTHER	FL	AETNA
3	78066	OTHER	FL	BLUE CROSS BLUE SHIELD
4	110716	OTHER	FL	HUMANA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508831504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL J HERSCH MD

Provider Business Mailing Address
First Line	:	4959 N STATE RD 7
Second Line	:	STE C
City	:	TAMARAC
State	:	FL
Zip	:	33319
Country	:	US
Telephone Number	:	954-484-8850
Fax Number	:	954-484-8851

Provider Business Practice Location Address
First Line	:	4959 N STATE RD 7
Second Line	:	STE C
City	:	TAMARAC
State	:	FL
Zip	:	33319
Country	:	US
Telephone Number	:	954-484-8850
Fax Number	:	954-484-8851

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	09/20/2007

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