MEDICARE: ONEDO RICARDO HERRERA GONZALEZ 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
1	208D00000X	General Practice Physician	19252	PR
2	208D00000X	General Practice Physician	ACN950	FL

General Provider Information

NPI Number	:	1932567567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONEDO RICARDO HERRERA GONZALEZ M.D.

Provider Business Mailing Address
First Line	:	950 SW 57TH AVE APT 539
Second Line	:
City	:	WEST MIAMI
State	:	FL
Zip	:	33144-5092
Country	:	US
Telephone Number	:	786-660-9377
Fax Number	:

Provider Business Practice Location Address
First Line	:	3448 NW 79TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33147-4602
Country	:	US
Telephone Number	:	855-226-6633
Fax Number	:

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

Provider Enumeration Date	:	02/10/2016
Last Update Date	:	03/10/2022

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