MEDICARE: EDUARDO GONZALEZ-HERNANDEZ MD PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP2000X	Physical Therapy Clinic/Center
2	261QM1300X	Multi-Specialty Clinic/Center
3	174400000X	Specialist

Other Identifiers

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

General Provider Information

NPI Number	:	1790910982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDUARDO GONZALEZ-HERNANDEZ MD PLLC

Provider Business Mailing Address
First Line	:	401 SW 42ND AVE
Second Line	:	SUITE 200
City	:	MIAMI
State	:	FL
Zip	:	33134-1938
Country	:	US
Telephone Number	:	786-270-3914
Fax Number	:	786-270-3986

Provider Business Practice Location Address
First Line	:	401 SW 42ND AVE
Second Line	:	SUITE 200
City	:	MIAMI
State	:	FL
Zip	:	33134-1938
Country	:	US
Telephone Number	:	786-270-3914
Fax Number	:	786-270-3986

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	EDUARDO GONZALEZ-HERNANDEZ
Credential	:	MD
Telephone Number	:	786-270-3914

Provider Enumeration Date	:	05/18/2009
Last Update Date	:	06/09/2022

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