Healthcare Provider Details

I. General information

NPI: 1043600414
Provider Name (Legal Business Name): DR. SERGIO HERNANDEZ BORGES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2015
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 W 49TH PL
HIALEAH FL
33012-3113
US

IV. Provider business mailing address

PO BOX 734951
CHICAGO IL
60673-4951
US

V. Phone/Fax

Practice location:
  • Phone: 305-558-2500
  • Fax:
Mailing address:
  • Phone: 702-899-0595
  • Fax: 702-977-1496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME 126433
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: