Provider Demographics
NPI:1326604885
Name:MIGUEL R GARDEN HERNANDEZ MD
Entity Type:Organization
Organization Name:MIGUEL R GARDEN HERNANDEZ MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT CERTIFIED SA-C
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:RODOLFO
Authorized Official - Last Name:GARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-487-9951
Mailing Address - Street 1:132 ALVIEW TER
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-7452
Mailing Address - Country:US
Mailing Address - Phone:786-487-9951
Mailing Address - Fax:
Practice Address - Street 1:2001 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3773
Practice Address - Country:US
Practice Address - Phone:786-487-9951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty