Healthcare Provider Details

I. General information

NPI: 1508032806
Provider Name (Legal Business Name): ROBERT J HERNANDEZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9240 SW 72ND ST STE 241
MIAMI FL
33173-3265
US

IV. Provider business mailing address

15421 SW 82ND AVE
PALMETTO BAY FL
33157-2215
US

V. Phone/Fax

Practice location:
  • Phone: 305-271-1919
  • Fax: 305-271-1911
Mailing address:
  • Phone: 786-348-5921
  • Fax: 305-271-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME93218
License Number StateFL

VIII. Authorized Official

Name: DR. ROBERT J HERNANDEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 786-348-5921