Healthcare Provider Details

I. General information

NPI: 1740344183
Provider Name (Legal Business Name): FRANCISCO J. HERNANDEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 N 35TH AVE STE 7
PHOENIX AZ
85017-5270
US

IV. Provider business mailing address

3140 N 35TH AVE STE 7
PHOENIX AZ
85017-5270
US

V. Phone/Fax

Practice location:
  • Phone: 602-353-6656
  • Fax: 602-442-2065
Mailing address:
  • Phone: 602-353-6656
  • Fax: 602-442-2065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20754
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number20754
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: