Provider Demographics
NPI:1376522847
Name:HERNANDEZ CONTE, ANTONIO T (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:T
Last Name:HERNANDEZ CONTE
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 1:3530 WILSHIRE BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2335
Mailing Address - Country:US
Mailing Address - Phone:954-493-5005
Mailing Address - Fax:954-938-0957
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:SUITE 8211
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:954-493-5005
Practice Address - Fax:954-938-0957
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79978A207L00000X
FLME0067561174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050063732OtherRAILROAD MEDICARE
FL285590OtherAVMED
FL31699OtherBCBS OF FLORIDA
FL250998900Medicaid
FL31699ZMedicare ID - Type Unspecified