Provider Demographics
NPI:1538335013
Name:NORMAN L. HERSKOVICH, O.D. & ASSOCIATES, INC.
Entity type:Organization
Organization Name:NORMAN L. HERSKOVICH, O.D. & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HERSKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-491-6663
Mailing Address - Street 1:5200 N FEDERAL HWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3253
Mailing Address - Country:US
Mailing Address - Phone:954-491-6663
Mailing Address - Fax:954-491-6697
Practice Address - Street 1:5200 N FEDERAL HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3253
Practice Address - Country:US
Practice Address - Phone:954-491-6663
Practice Address - Fax:954-491-6697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLOPC3236152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty