| Doctor Name: | MS. JENNA HERMAN |
| NPI Number: | 1104295047 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA9108888 |
| Business Practice Address: | 18300 Nw 62nd Ave Suite 300 Miami Gardens, FL - 330158200 |
| Business Phone Number: | 3056284600 |
| Business Fax Number: | 3056288090 |
| Mailing Address: | 212 Three Islands Blvd, Apt 204 HALLANDALE BEACH |
| State: | FL |
| Postal Code: | 330097323 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/22/2015 |
| NPI Last Update Date: | 09/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9108888 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |