Provider Demographics
NPI:1407009566
Name:HERNANDEZ, RUBEN II (ARRT (R))
Entity Type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:
Last Name:HERNANDEZ
Suffix:II
Gender:M
Credentials:ARRT (R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 W 29TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5707
Mailing Address - Country:US
Mailing Address - Phone:786-662-9177
Mailing Address - Fax:305-381-5465
Practice Address - Street 1:387 W 29TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5707
Practice Address - Country:US
Practice Address - Phone:786-662-9177
Practice Address - Fax:305-381-5465
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-02
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL61478261QR0206X
261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography