Organization
RAUL J HERRADA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEISY H GONZALEZ (OFFICE MANAGER)
(407) 896-4147
Entity
Organization
Contact information
Practice address
2177 E MICHIGAN ST, SUITE 1, ORLANDO, FL 32806-4948
(407) 896-4147
(407) 895-7182
Mailing address
2177 EAST MICHIGAN STREET, SUITE 1, ORLANDO, FL 32806-4948
(407) 896-4147
(407) 895-7182
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME0026137
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038505100
—
FL
Enumeration date
05/03/2010
Last updated
06/04/2010
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