Provider Demographics
NPI:1568468973
Name:HERMANN, ERIC F (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:F
Last Name:HERMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 E OCEAN AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-5011
Mailing Address - Country:US
Mailing Address - Phone:561-733-8500
Mailing Address - Fax:561-733-8600
Practice Address - Street 1:639 E OCEAN AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-5011
Practice Address - Country:US
Practice Address - Phone:561-733-8500
Practice Address - Fax:561-733-8600
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55391OtherBCBS
FL380914500Medicaid
FL55391ZMedicare PIN
U61014Medicare UPIN