Provider Demographics
NPI:1790887313
Name:HERNANDEZ, EUGENIO J (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENIO
Middle Name:J
Last Name:HERNANDEZ
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 1:8950 N KENDALL DR STE 306
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2131
Mailing Address - Country:US
Mailing Address - Phone:305-596-9966
Mailing Address - Fax:305-596-5752
Practice Address - Street 1:8950 N KENDALL DR STE 306
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2131
Practice Address - Country:US
Practice Address - Phone:305-596-9966
Practice Address - Fax:305-596-5752
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70525207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253529700Medicaid
FL253529700Medicaid
FL41662AMedicare ID - Type Unspecified