Provider Demographics
NPI:1871598714
Name:HERSCHMANN, ELIAS M (MD)
Entity type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:M
Last Name:HERSCHMANN
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 1:4430 PINE TREE DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3132
Mailing Address - Country:US
Mailing Address - Phone:305-491-2233
Mailing Address - Fax:305-531-7784
Practice Address - Street 1:4430 PINE TREE DR
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3132
Practice Address - Country:US
Practice Address - Phone:305-491-2233
Practice Address - Fax:305-531-7784
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0015129174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD59486Medicare UPIN