Individual
KENNETH HERSKOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1625 SE 3RD AVE, SUITE 300, FORT LAUDERDALE, FL 33316-2521
(954) 355-4665
(954) 355-4881
Mailing address
1608 SE 3RD AVE, THIRD FLOOR, FORT LAUDERDALE, FL 33316-2564
(954) 355-4665
(954) 355-4881
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME0062923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25284
FLORIDA BLUE
FL
05
—
375318200
—
FL
Enumeration date
06/09/2006
Last updated
04/10/2014
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