Healthcare Provider Details

I. General information

NPI: 1255792149
Provider Name (Legal Business Name): LYNN M HERNANDEZ-RIZO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN M HERNANDEZ D.O.

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD
MIAMI BEACH FL
33140-2948
US

IV. Provider business mailing address

4300 ALTON RD
MIAMI BEACH FL
33140-2948
US

V. Phone/Fax

Practice location:
  • Phone: 305-481-9776
  • Fax: 305-674-2007
Mailing address:
  • Phone: 786-475-4970
  • Fax: 337-289-6006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOS15997
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS15997
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: