Provider Demographics
NPI:1205078649
Name:HERNANDEZ, LUIS OSCAR III (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:OSCAR
Last Name:HERNANDEZ
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:9500 S DADELAND BLVD
Mailing Address - Street 2:200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156
Mailing Address - Country:US
Mailing Address - Phone:305-468-4185
Mailing Address - Fax:305-596-3073
Practice Address - Street 1:7765 SW 87TH AVENUE
Practice Address - Street 2:212
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173
Practice Address - Country:US
Practice Address - Phone:305-596-3080
Practice Address - Fax:305-596-3073
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2020-08-07
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Provider Licenses
StateLicense IDTaxonomies
FLTRN 13872208600000X
FLME124589208C00000X
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program