Individual provider Active NPI

Eugene R Hershorin, MD

  • Developmental - Behavioral Pediatrics Physician
  • Miami, FL
National Provider Identifier
1184687154
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
ME34379 Issued in FL
Practice address
1475 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1002
Phone
(305) 243-7249
Fax
(305) 243-8470
NPI assigned
Apr 10, 2006
Last updated
Nov 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X ME34379 FL Primary

Addresses

Primary practice location

1475 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1002

Mailing address

1475 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1002
Phone (305) 243-7249

Other identifiers 1

IdentifierTypeStateIssuer
2516471-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101230000857 FL Practitioner - Pediatric Medicine 0345438610 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians Inc Developmental - Behavioral Pediatrics CurrentSince Apr 30, 2021 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Apr 30, 2021 Accepting new patients
University of Miami Developmental - Behavioral Pediatrics CurrentSince Jan 1, 2020 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

1475 NW 12th Ave
#16960
Miami, FL 33136
Phone (305) 243-4058

1475 NW 12th Ave
#C130
Miami, FL 33136
Phone (305) 243-0837

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

8932 SW 97th Ave
Miami, FL 33176
Phone (305) 270-3485

Interoperability endpoints

  • Direct secure messaging: ehershorin523641@direct.shands.ufl.edu

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1184687154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "address_2": "BOX 016960 M851",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-7249",
            "fax_number": "305-243-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "address_2": "BOX 016960 M851",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-7249",
            "fax_number": "305-243-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHORIN",
        "first_name": "EUGENE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "FL",
            "license": "ME34379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2516471-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.