MEDICARE: ERIC F HERMANN DC

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	111N00000X	Chiropractor	CH7072	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	55391	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568468973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC F HERMANN DC

Provider Business Mailing Address
First Line	:	639 E OCEAN AVE
Second Line	:	SUITE 107
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-5011
Country	:	US
Telephone Number	:	561-733-8500
Fax Number	:	561-733-8600

Provider Business Practice Location Address
First Line	:	639 E OCEAN AVE
Second Line	:	SUITE 107
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-5011
Country	:	US
Telephone Number	:	561-733-8500
Fax Number	:	561-733-8600

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	11/15/2013

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