Provider Demographics
NPI:1881807634
Name:HERNANDEZ, FERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:
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 1:305 ALHAMBRA CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5003
Mailing Address - Country:US
Mailing Address - Phone:305-445-3999
Mailing Address - Fax:305-722-3648
Practice Address - Street 1:305 ALHAMBRA CIRCLE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5003
Practice Address - Country:US
Practice Address - Phone:305-445-3999
Practice Address - Fax:305-722-3648
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42729207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD50495Medicare UPIN
FL02401Medicare ID - Type Unspecified