Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO 3517 | FL |
NPI | 1043594062 |
---|---|
Provider Name | Dr. Victor Luis Herrera |
First Address | Hialeah, FL 33015-6252 |
Second Address | Miami, FL 33133-4227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2011 |
Last Update Date | 11/10/2011 |