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NPI Code Detail

MEDICARE: MR. MARK HERT CRNA

MEDICARE:  MR. MARK  HERT  CRNA
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
1367500000XCertified Registered Nurse AnesthetistARNP9201844FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G1154OTHERFLBCBSFL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689706830
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK HERT CRNA
Provider Business Mailing Address
First Line : 2001 N FLAGLER DR
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33407-6109
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 N FLAGLER DR
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33407-6109
Country : US
Telephone Number : 561-721-8755
Fax Number : 561-340-1095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 08/19/2020

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