Individual
MICHAEL K. HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
8303 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(352) 688-8200
Mailing address
8303 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(352) 688-8200
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD.11684R
LA
2085R0202X
Diagnostic Radiology Physician
Primary
ME84779
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267384300
—
FL
01
—
81554
BCBS
FL
01
—
P00060963
RR MEDICARE
FL
01
—
P00352559
RR MEDICARE
FL
Enumeration date
11/10/2005
Last updated
09/14/2020
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