Provider Demographics
NPI:1154723666
Name:MERSON, HOWARD
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:MERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8571 BOCA GLADES BLVD W APT A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4045
Mailing Address - Country:US
Mailing Address - Phone:561-307-1974
Mailing Address - Fax:
Practice Address - Street 1:8571 BOCA GLADES BLVD W APT A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4045
Practice Address - Country:US
Practice Address - Phone:561-307-1974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54965207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology