Healthcare Provider Details

I. General information

NPI: 1265413538
Provider Name (Legal Business Name): FRANCISCO OMAR HERNANDEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13391 SW 34TH ST
MIAMI FL
33175-6908
US

IV. Provider business mailing address

13391 SW 34TH ST
MIAMI FL
33175-6908
US

V. Phone/Fax

Practice location:
  • Phone: 786-301-5405
  • Fax: 305-413-4209
Mailing address:
  • Phone: 786-301-5405
  • Fax: 305-413-4209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME0057020
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: