Provider Demographics
NPI:1902837222
Name:DRS SEGALL & HERZBERG PA
Entity Type:Organization
Organization Name:DRS SEGALL & HERZBERG PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:SEGALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-538-8504
Mailing Address - Street 1:4302 ALTON RD
Mailing Address - Street 2:SUITE750
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2891
Mailing Address - Country:US
Mailing Address - Phone:305-538-8504
Mailing Address - Fax:305-538-1487
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE750
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-538-8504
Practice Address - Fax:305-538-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00097Medicare PIN