Provider Demographics
NPI:1376865923
Name:HERNANDEZ RODRIGUEZ, YOEL A SR (MD)
Entity Type:Individual
Prefix:DR
First Name:YOEL
Middle Name:A
Last Name:HERNANDEZ RODRIGUEZ
Suffix:SR
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 1:13079 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2549
Mailing Address - Country:US
Mailing Address - Phone:954-256-8181
Mailing Address - Fax:
Practice Address - Street 1:1951 SW 172ND AVE
Practice Address - Street 2:STE 200
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5593
Practice Address - Country:US
Practice Address - Phone:954-256-8181
Practice Address - Fax:954-256-8155
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL282N00000X
FLME106099207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME106099OtherMEDICAL LICENSE