Provider Demographics
NPI:1811985708
Name:HERNANDO, ROBERTO ALEJANDRO (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:ALEJANDRO
Last Name:HERNANDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9350 SUNSET DR STE 151
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3286
Mailing Address - Country:US
Mailing Address - Phone:786-548-1022
Mailing Address - Fax:786-542-5326
Practice Address - Street 1:9350 SUNSET DR STE 151
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3286
Practice Address - Country:US
Practice Address - Phone:305-274-9206
Practice Address - Fax:305-274-9254
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME874732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL124773300Medicaid
FL014767300Medicaid
FLH89043Medicare UPIN
FLU0974XMedicare UPIN
FLU0974VMedicare UPIN