Provider Demographics
NPI:1417193582
Name:BIRKNER, HERMAN JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:JOSEPH
Last Name:BIRKNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 CARIBBEAN DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5303
Mailing Address - Country:US
Mailing Address - Phone:941-924-3749
Mailing Address - Fax:941-929-7559
Practice Address - Street 1:1537 CARIBBEAN DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5303
Practice Address - Country:US
Practice Address - Phone:941-924-3749
Practice Address - Fax:941-929-7559
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME27269207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78913Medicare PIN