Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | ME140504 | FL |
N | 2081P2900X | Pain Medicine | 201050 | NY |
NPI | 1053361154 |
---|---|
Provider Name | Pierre R Herard |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33908-9687 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01826815 | (05) | NY |
105455800 | (05) | FL |
G53174 | (02) | NY |