Individual
DR. JOSE DAVID HERAZO-MAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
311 9TH ST N STE 310, NAPLES, FL 34102-5889
(239) 624-8250
(239) 624-8251
Mailing address
311 9TH ST N STE 310, NAPLES, FL 34102-5889
(239) 624-8250
(239) 624-8251
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
052191
CT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME129944
FL
207RP1001X
Pulmonary Disease Physician
052191
CT
207RP1001X
Pulmonary Disease Physician
Primary
ME129944
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020542800
—
FL
01
—
IY355Z
MEDICARE
FL
01
—
JJEOQ
BCBS
FL
Enumeration date
06/28/2008
Last updated
07/21/2022
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