Individual
DAVID M HERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21756 STATE ROAD 54, SUITE 102A, LUTZ, FL 33549-2905
(813) 443-5817
(813) 443-5818
Mailing address
14701 CROYDON PL, TAMPA, FL 33618-2160
(813) 443-5817
(813) 443-5818
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME61297
FL
208VP0000X
Pain Medicine Physician
Primary
ME61297
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2593507
CIGNA
FL
05
—
261340900
—
FL
01
—
279800
AVMED
FL
01
—
4565372
AETNA
FL
01
—
58760
BCBS OF FL
FL
01
—
720000186
RAILROAD MEDICARE
FL
Enumeration date
06/17/2005
Last updated
08/24/2009
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