Provider Demographics
NPI:1871523142
Name:HERBERT, ROBERT ALAN
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALAN
Last Name:HERBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S OCEAN BLVD
Mailing Address - Street 2:PH1
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-7400
Mailing Address - Country:US
Mailing Address - Phone:954-785-5999
Mailing Address - Fax:
Practice Address - Street 1:1500 S OCEAN BLVD
Practice Address - Street 2:PH1
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-7400
Practice Address - Country:US
Practice Address - Phone:954-785-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74795207L00000X
NJ25MA04991600207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology