Provider Demographics
NPI:1952366197
Name:HERNANDEZ-CASSIS, CARLOS (MD, MPH)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:HERNANDEZ-CASSIS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10561 JEFFREYS ST STE 211
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4268
Mailing Address - Country:US
Mailing Address - Phone:702-990-4530
Mailing Address - Fax:702-990-4527
Practice Address - Street 1:10561 JEFFREYS ST STE 211
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4268
Practice Address - Country:US
Practice Address - Phone:702-636-3000
Practice Address - Fax:702-636-3000
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79301207RE0101X
NV18366207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258766100Medicaid
FL35287Medicare ID - Type Unspecified
FL258766100Medicaid