Individual
MILAGRO ESMERALDA HEREDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
608 INGRAHAM AVE, HAINES CITY, FL 33844-4330
(863) 422-9562
(863) 421-3246
Mailing address
PO BOX 4189, DEERFIELD BEACH, FL 33442-4189
(954) 363-9582
(954) 363-9663
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ACN1447
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116755000
—
FL
Enumeration date
06/13/2019
Last updated
05/17/2024
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