Individual provider Active NPI

Isabella Mariel Herrera

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Maitland, FL
National Provider Identifier
1487158572
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
License
ME161694 Issued in FL
Practice address
790 Concourse Pkwy S Ste 200
Maitland, FL 32751-6114
Phone
(407) 767-6411
NPI assigned
Mar 22, 2018
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME161694 FL
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X ME161694 FL Primary

Addresses

Primary practice location

790 Concourse Pkwy S Ste 200
Maitland, FL 32751-6114

Mailing address

14250 Nottingham Way Cir
Orlando, FL 32828-7802

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
I20240314000181 FL Practitioner - Ophthalmology 0143666024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Kansas School of Med (KC/Wich/Sal), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

790 Concourse Pkwy S
Suite 200
Maitland, FL 32751-6114
Phone (407) 767-6411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME161694FLMDPediatric Ophthalmology and Strabismus Specialist Physician Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pediatric Associates LLC CurrentSince Feb 7, 2024 Accepting new patients
Florida Pediatric Associates, LLC Ophthalmology CurrentSince Feb 7, 2024 Accepting new patients

Locations

790 Concourse Pkwy S
Ste 200
Maitland, FL 32751
Phone (407) 767-6411

1781 Park Center Dr
Ste 220
Orlando, FL 32835
Phone (407) 398-7730

1800 Dr Martin Luther King St N
St Petersburg, FL 33704
Phone (727) 821-2121

Interoperability endpoints

  • Direct secure messaging: iherrera@epcf.intellechartdirect.net
  • Direct secure messaging: iherrera91420@direct.phhs.org

Organizations & group practices 2

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": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1487158572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14250 NOTTINGHAM WAY CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CONCOURSE PKWY S STE 200",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516114",
            "telephone_number": "407-767-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "ISABELLA MARIEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME161694",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "FL",
            "license": "ME161694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.