Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | ME0056448 | FL |
Y | 207R00000X | Internist | ME0056448 | FL |
Y | 111NI0900X | Internist | ME0056448 | FL |
N | 207RG0300X | Geriatric Medicine | ME0056448 | FL |
NPI | 1144219270 |
---|---|
Provider Name | Dr. Kenneth David Hershman |
First Address | Miami, FL 33186-7441 |
Second Address | Miami, FL 33186 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 01/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
056964000 | (05) | FL |
E96853 | (02) | |
E96853 | (02) | FL |