Provider Demographics
NPI:1972882058
Name:HERGER, ERNESTO JOSE (DOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:JOSE
Last Name:HERGER
Suffix:
Gender:M
Credentials:DOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 WEST AVE UNIT 5
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-1440
Mailing Address - Country:US
Mailing Address - Phone:786-464-9655
Mailing Address - Fax:786-369-0195
Practice Address - Street 1:1819 WEST AVE UNIT 5
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-1440
Practice Address - Country:US
Practice Address - Phone:786-464-9655
Practice Address - Fax:786-369-0195
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2685171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist