MEDICARE: HEROLD PIERRE-LOUIS 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	208D00000X	General Practice Physician	ACN1700	FL

General Provider Information

NPI Number	:	1790336972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEROLD PIERRE-LOUIS MD

Provider Business Mailing Address
First Line	:	1037 W US HIGHWAY 90 STE 130
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-3740
Country	:	US
Telephone Number	:	386-487-6357
Fax Number	:

Provider Business Practice Location Address
First Line	:	1037 W US HIGHWAY 90 STE 130
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-3740
Country	:	US
Telephone Number	:	864-876-3573
Fax Number	:

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

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	02/14/2025

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Directions to “ HEROLD PIERRE-LOUIS MD” Practice Location

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