Healthcare Provider Details

I. General information

NPI: 1578515532
Provider Name (Legal Business Name): EDUARDO GONZALEZ-HERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 SW 42ND AVE SUITE 200
CORAL GABLES FL
33134-1938
US

IV. Provider business mailing address

401 SW 42ND AVE SUITE 200
CORAL GABLES FL
33134-1938
US

V. Phone/Fax

Practice location:
  • Phone: 305-443-4493
  • Fax: 305-443-4496
Mailing address:
  • Phone: 305-443-4493
  • Fax: 305-443-4496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME80486
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME80486
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME80486
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME80486
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: