Provider Demographics
NPI:1407607393
Name:HERSON, ANDREW BRIAN (DO)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:BRIAN
Last Name:HERSON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 W 49TH PL STE 604
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3158
Mailing Address - Country:US
Mailing Address - Phone:361-945-6475
Mailing Address - Fax:786-456-8404
Practice Address - Street 1:1435 W 49TH PL STE 604
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3158
Practice Address - Country:US
Practice Address - Phone:361-945-6475
Practice Address - Fax:786-456-8404
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program