Individual
DR. ANTHONY JAY HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1425 MALABAR RD NE, PALM BAY, FL 32907-2506
(321) 434-8078
(321) 434-8075
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-8078
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
ME130900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021034100
—
FL
01
—
IZ735Z
MEDICARE
FL
Enumeration date
06/24/2013
Last updated
05/09/2018
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