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NPI Code Detail

MEDICARE: DR. MARIA CONSUELO HERNANDEZ D.C.

MEDICARE: DR. MARIA CONSUELO HERNANDEZ D.C.
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
1111N00000XChiropractorCH 10452FL

General Provider Information

NPI Number : 1487841052
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIA CONSUELO HERNANDEZ D.C.
Provider Business Mailing Address
First Line : 6225 GANNETDALE DR
Second Line :
City : LITHIA
State : FL
Zip : 33547-4823
Country : US
Telephone Number : 813-335-9605
Fax Number :
Provider Business Practice Location Address
First Line : 716 S OAKWOOD AVE
Second Line :
City : BRANDON
State : FL
Zip : 33511-6124
Country : US
Telephone Number : 813-999-2008
Fax Number : 813-995-0558
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2007
Last Update Date : 10/28/2013

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