Provider Demographics
NPI:1760132922
Name:RICE, TROY KENNETT HERRERA (DO)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:KENNETT HERRERA
Last Name:RICE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:TROY
Other - Middle Name:KENNETT
Other - Last Name:HERRERA-RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4813 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6188
Practice Address - Country:US
Practice Address - Phone:725-231-9260
Practice Address - Fax:833-749-0364
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NV1066226428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program