MEDICARE: DR. ALLAN A HERNANDEZ MD

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	207Q00000X	Family Medicine Physician	ME0092572	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01581	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386614592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLAN A HERNANDEZ MD

Provider Business Mailing Address
First Line	:	4301 SW 13TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33134-2726
Country	:	US
Telephone Number	:	786-547-1780
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 SW 13TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33134-2726
Country	:	US
Telephone Number	:	786-547-1780
Fax Number	:

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	08/08/2007

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