Healthcare Provider Details

I. General information

NPI: 1881679421
Provider Name (Legal Business Name): MARK A HERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

PO BOX 165154
MIAMI FL
33116-5154
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-3415
  • Fax:
Mailing address:
  • Phone: 786-882-1919
  • Fax: 786-206-3161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME84218
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME84218
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: