Provider Demographics
NPI:1821262239
Name:DAVID HERSCHTHAL MD PA
Entity type:Organization
Organization Name:DAVID HERSCHTHAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-391-9200
Mailing Address - Street 1:7280 W PALMETTO PARK RD STE 210
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3412
Mailing Address - Country:US
Mailing Address - Phone:561-391-9200
Mailing Address - Fax:561-338-7027
Practice Address - Street 1:7280 W PALMETTO PARK RD STE 210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3412
Practice Address - Country:US
Practice Address - Phone:561-391-9200
Practice Address - Fax:561-338-7027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 31531174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAJ766Medicare PIN