MEDICARE: MR. VINICIO 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
1	207RH0003X	Hematology & Oncology Physician	ME73340	FL

General Provider Information

NPI Number	:	1154312783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINICIO HERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	7301 STONEROCK CIR
Second Line	:	SUITE 2
City	:	ORLANDO
State	:	FL
Zip	:	32819-8002
Country	:	US
Telephone Number	:	407-351-1002
Fax Number	:	407-351-1119

Provider Business Practice Location Address
First Line	:	7301 STONEROCK CIRCLE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819
Country	:	US
Telephone Number	:	407-351-1002
Fax Number	:	407-351-1096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	12/17/2019

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