Healthcare Provider Details

I. General information

NPI: 1497546030
Provider Name (Legal Business Name): FULL MEDICAL SERVICES CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5970 SW 7TH ST
MIAMI FL
33144-3936
US

IV. Provider business mailing address

5970 SW 7TH ST
MIAMI FL
33144-3936
US

V. Phone/Fax

Practice location:
  • Phone: 786-542-3801
  • Fax: 305-255-1669
Mailing address:
  • Phone: 786-542-3801
  • Fax: 305-255-1669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSE M. HERNANDEZ GUTIERREZ
Title or Position: OWNER
Credential: APRN
Phone: 786-542-3801