Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO02861 | FL |
NPI | 1013906965 |
---|---|
Provider Name | Alberto Herrada |
First Address | Davie, FL 33328-3208 |
Second Address | Davie, FL 33328-3208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 10/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
340154500 | (05) | FL |
U81290 | (02) | FL |