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NPI Code Detail

MEDICARE: RAUL HERNANDEZ M.D.

MEDICARE: RAUL HERNANDEZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician017968ME
2207P00000XEmergency Medicine PhysicianME0043960FL
3207P00000XEmergency Medicine Physician44108KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
296707OTHERFLBCBS

General Provider Information

NPI Number : 1093708331
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAUL HERNANDEZ M.D.
Provider Business Mailing Address
First Line : 1301 BRISTOL AVE
Second Line :
City : DAVIE
State : FL
Zip : 33325-6510
Country : US
Telephone Number : 954-232-3643
Fax Number :
Provider Business Practice Location Address
First Line : 900 HOSPITAL DR
Second Line :
City : MADISONVILLE
State : KY
Zip : 42431-1644
Country : US
Telephone Number : 954-232-3643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 04/03/2015

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