Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | ME68223 | FL |
NPI | 1073508180 |
---|---|
Provider Name | German Herrera |
First Address | Pensacola, FL 32505-2254 |
Second Address | Pensacola, FL 32501-6339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 17/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009506620 | (05) | AL |
378496700 | (05) | FL |
E76702 | (02) | FL |