Provider Demographics
NPI:1922055375
Name:HERTZ, BARRY CHESTER (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:CHESTER
Last Name:HERTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3021 AIRPORT PULLING RD N
Mailing Address - Street 2:STE 103
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-3077
Mailing Address - Country:US
Mailing Address - Phone:239-213-7000
Mailing Address - Fax:239-430-7824
Practice Address - Street 1:3021 AIRPORT PULLING RD N
Practice Address - Street 2:STE 103
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-3077
Practice Address - Country:US
Practice Address - Phone:239-213-7000
Practice Address - Fax:239-430-7824
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018425E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA479914Medicare ID - Type UnspecifiedPROVIDER NUMBER