Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | OS6189 | FL |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | OS6189 | FL |
N | 207XX0801X | Orthopaedic Trauma Surgeon | OS6189 | FL |
NPI | 1609871326 |
---|---|
Provider Name | Dolfi Herscovici |
First Address | Temple Terrace, FL 33637-0925 |
Second Address | Hudson, FL 34667 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 11/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057424400 | (05) | FL |
1660813 | CIGNA (01) | FL |
200016605 | MEDICARE RAILROAD (01) | FL |
208505 | AVMED (01) | FL |
4224344 | AETNA (01) | FL |
80568 | BC/BS (01) | FL |