Healthcare Provider Details

I. General information

NPI: 1457059198
Provider Name (Legal Business Name): LUIS EMMANUEL HERNANDEZ RODRIGUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 07/12/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

2300 M ST NW FL 4
WASHINGTON DC
20037-1434
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-3000
  • Fax:
Mailing address:
  • Phone: 202-741-3250
  • Fax: 202-741-3382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMTL500002308
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: