Provider Demographics
NPI:1578541058
Name:HERRERA, ROSA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:MARIA
Last Name:HERRERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1551 SAWGRASS CORPORATE PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2828
Mailing Address - Country:US
Mailing Address - Phone:954-835-0750
Mailing Address - Fax:954-835-0760
Practice Address - Street 1:1551 SAWGRASS CORPORATE PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2828
Practice Address - Country:US
Practice Address - Phone:954-835-0750
Practice Address - Fax:954-835-0760
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME78626207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG05015Medicare UPIN
FL5W175Medicare ID - Type Unspecified