MEDICARE: TROY KENNETT HERRERA RICE DO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	1066226428	NV

General Provider Information

NPI Number	:	1760132922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY KENNETT HERRERA RICE DO

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4813 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6188
Country	:	US
Telephone Number	:	725-231-9260
Fax Number	:	833-749-0364

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

Provider Enumeration Date	:	03/28/2022
Last Update Date	:	02/13/2026

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