Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kristine C Hertzog, PA

Individual provider Physician Assistant · NPI 1750546040

Kristine C Hertzog, PA is a Physician Assistant in Titusville, Florida. Qualified in 2008, 18 years ago. Practices with Brevard Medical Dermatology, PA, a 9-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
18
Licensed in
FL
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

805 Century Medical Dr Ste A
Titusville, FL 32796-2100
Phone: (321) 567-7530
Fax: (321) 225-8723
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9104652 (FL)
Physician Assistant Taxonomy 363A00000X · Licence PA9104652 (FL)

Record details

NPI number1750546040
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 25, 2008
Last updated in NPPESFebruary 11, 2025
Certification dateFebruary 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Brevard Medical Dermatology, Pa — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Titusville