Provider Demographics
NPI:1720547003
Name:HERNANDEZ GONZALEZ, HECTOR EMILIO (NP-C)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:EMILIO
Last Name:HERNANDEZ GONZALEZ
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6610 SW 159TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3653
Mailing Address - Country:US
Mailing Address - Phone:305-305-8540
Mailing Address - Fax:
Practice Address - Street 1:6610 SW 159TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3653
Practice Address - Country:US
Practice Address - Phone:305-305-8540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-17
Last Update Date:2019-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001581207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine