Provider Demographics
NPI:1043594062
Name:HERRERA, VICTOR LUIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:LUIS
Last Name:HERRERA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7060 NW 177TH ST
Mailing Address - Street 2:100
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-6252
Mailing Address - Country:US
Mailing Address - Phone:305-773-5096
Mailing Address - Fax:
Practice Address - Street 1:3659 S MIAMI AVE
Practice Address - Street 2:BAYSIDE, SUITE 3008
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4227
Practice Address - Country:US
Practice Address - Phone:305-859-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPOD-001096213ES0103X
FLPO 3517213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery