Individual provider Active NPI

Cesar Miguel Herrera, M.D.

  • General Practice Physician
  • Port St Lucie, FL
National Provider Identifier
1821212580
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN661 Issued in FL
Practice address
672 SW Prima Vista Blvd Ste 101
Port St Lucie, FL 34983-1820
Phone
(772) 905-2555
Fax
(772) 336-8153
NPI assigned
Apr 12, 2007
Last updated
Feb 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN661 FL Primary

Addresses

Primary practice location

672 SW Prima Vista Blvd Ste 101
Port St Lucie, FL 34983-1820

Mailing address

PO Box 4189
Deerfield Beach, FL 33442-4189
Phone (954) 363-9582

Other practice location 1

9109 S US Highway 1 Ste 101
Port St Lucie, FL 34952-3453
Phone (772) 398-1305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Consultants of Florida, LLC CurrentSince Dec 3, 2023 Accepting new patients

Locations

9109 S US Highway 1
Ste 101
Port St Lucie, FL 34952
Phone (772) 398-1305

Organizations & group practices 1

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1821212580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4189",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334424189",
            "telephone_number": "954-363-9582",
            "fax_number": "954-363-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 SW PRIMA VISTA BLVD STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831820",
            "telephone_number": "772-905-2555",
            "fax_number": "772-336-8153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9109 S US Highway 1 Ste 101",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349523453",
            "country_code": "US",
            "telephone_number": "772-398-1305",
            "fax_number": "772-398-1307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "CESAR",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.