Provider Demographics
NPI:1801252895
Name:HERNANDEZ ROMAN, JULIO CESAR (PA-C)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:HERNANDEZ ROMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 SW 27TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2332
Mailing Address - Country:US
Mailing Address - Phone:786-231-8183
Mailing Address - Fax:
Practice Address - Street 1:2525 SW 75TH AVE FL 12
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2800
Practice Address - Country:US
Practice Address - Phone:305-262-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2016002363AM0700X
FLPA9113605363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical