Individual
MARK KELLAND HERSCHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5452 LAKE HOWELL ROAD, WINTER PARK, FL 32792
(407) 894-8081
(407) 894-8082
Mailing address
5452 LAKE HOWELL RD, WINTER PARK, FL 32792
(407) 894-8081
(407) 894-8082
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
ME77485
FL
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
ME77485
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1476870
CIGNA
FL
01
—
1689235
UNITED HEALTH CARE
FL
01
—
20922
BCBS
FL
01
—
209665
WELL CARE
FL
01
—
2439416
AETNA HMO
FL
05
—
25622700
—
FL
01
—
400650
GHI
FL
01
—
5014060
AETNAPPO/POS
FL
Enumeration date
04/20/2006
Last updated
02/14/2023
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