Individual
DR. JAY S. HERBST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2866 TAMIAMI TRL STE A, PORT CHARLOTTE, FL 33952-5165
(941) 764-1055
(941) 764-7984
Mailing address
2866 TAMIAMI TRL STE A, PORT CHARLOTTE, FL 33952-5165
(941) 764-1055
(941) 764-7984
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME0046734
FL
207ND0101X
MOHS-Micrographic Surgery Physician
ME0046734
FL
207ND0900X
Dermatopathology Physician
ME0046734
FL
207NS0135X
Procedural Dermatology Physician
ME0046734
FL
Other
Enumeration date
12/09/2006
Last updated
03/19/2012
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