Provider Demographics
NPI:1134181605
Name:HEROMIN, RONALD JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JOHN
Last Name:HEROMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2387 W. 68TH ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016
Mailing Address - Country:US
Mailing Address - Phone:786-336-1991
Mailing Address - Fax:786-336-1994
Practice Address - Street 1:2387 W. 68TH ST
Practice Address - Street 2:SUITE 502
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:786-336-1991
Practice Address - Fax:786-336-1994
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47301207X00000X
FLME00047301207X00000X
TN43119207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD50803Medicare UPIN
FL037132Medicare PIN
FL03713ZMedicare PIN