Provider Demographics
NPI:1134170897
Name:HERRERA, MARIA A (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9960 NW 116TH WAY
Mailing Address - Street 2:SUITE 13
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1167
Mailing Address - Country:US
Mailing Address - Phone:786-924-1311
Mailing Address - Fax:786-924-1313
Practice Address - Street 1:400 N HIATUS RD STE 200
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5214
Practice Address - Country:US
Practice Address - Phone:954-367-5166
Practice Address - Fax:954-639-7799
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME00824342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266375900Medicaid
FLH77505Medicare UPIN
FL266375900Medicaid