Basic Information
| Provider Information | |||||||||
| NPI: | 1871523142 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HERBERT | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | ALAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 S OCEAN BLVD | ||||||||
| Address2: | PH1 | ||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330627400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547855999 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 S OCEAN BLVD | ||||||||
| Address2: | PH1 | ||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330627400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547855999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | G74795 | CA | X | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 25MA04991600 | NJ | X | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.