Healthcare Provider Details

I. General information

NPI: 1790887313
Provider Name (Legal Business Name): EUGENIO J HERNANDEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR STE 306
MIAMI FL
33176-2131
US

IV. Provider business mailing address

8950 N KENDALL DR STE 306
MIAMI FL
33176-2131
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-9966
  • Fax: 305-596-5752
Mailing address:
  • Phone: 305-596-9966
  • Fax: 305-596-5752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME70525
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: