Healthcare Provider Details

I. General information

NPI: 1811207970
Provider Name (Legal Business Name): FATIMA MARTHA ZERQUERA HERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E HINSON AVE
HAINES CITY FL
33844-5240
US

IV. Provider business mailing address

738 NE 83RD TER
MIAMI FL
33138-3611
US

V. Phone/Fax

Practice location:
  • Phone: 305-278-0200
  • Fax:
Mailing address:
  • Phone: 786-397-2394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1558
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: