MEDICARE: KAREL LINO HERNANDEZ

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	225700000X	Massage Therapist	MA 66601	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA 66601	OTHER	FL	MASSAGE THERAPIST

General Provider Information

NPI Number	:	1821362641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREL LINO HERNANDEZ

Provider Business Mailing Address
First Line	:	2228 SW 29TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3339
Country	:	US
Telephone Number	:	786-975-5093
Fax Number	:

Provider Business Practice Location Address
First Line	:	2228 SW 29TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3339
Country	:	US
Telephone Number	:	786-975-5093
Fax Number	:

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

Provider Enumeration Date	:	02/24/2012
Last Update Date	:	02/24/2012

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Directions to “ KAREL LINO HERNANDEZ ” Practice Location

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