Provider Demographics
NPI:1265413538
Name:HERNANDEZ, FRANCISCO OMAR (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:OMAR
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 1:13391 SW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6908
Mailing Address - Country:US
Mailing Address - Phone:786-301-5405
Mailing Address - Fax:305-413-4209
Practice Address - Street 1:13391 SW 34TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6908
Practice Address - Country:US
Practice Address - Phone:786-301-5405
Practice Address - Fax:305-413-4209
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057020207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062856500Medicaid
FL062856500Medicaid
FLE52029Medicare UPIN