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NPI Code Detail

MEDICARE: DR. CHARLES HERRERA M.D.

MEDICARE: DR. CHARLES HERRERA M.D.
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
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianME0054912FL

General Provider Information

NPI Number : 1588628671
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES HERRERA M.D.
Provider Business Mailing Address
First Line : 6037 KIMBERLY BLVD
Second Line :
City : NORTH LAUDERDALE
State : FL
Zip : 33068-2811
Country : US
Telephone Number : 954-379-8994
Fax Number : 954-977-2711
Provider Business Practice Location Address
First Line : 6037 KIMBERLY BLVD
Second Line :
City : NORTH LAUDERDALE
State : FL
Zip : 33068-2811
Country : US
Telephone Number : 954-379-8994
Fax Number : 954-977-2711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 12/07/2020

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