Healthcare Provider Details

I. General information

NPI: 1487117305
Provider Name (Legal Business Name): STEVEN MICHAEL HERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 N ORANGE AVE STE 302
ORLANDO FL
32804-5505
US

IV. Provider business mailing address

2415 N ORANGE AVE STE 302
ORLANDO FL
32804-5505
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-7250
  • Fax:
Mailing address:
  • Phone: 407-303-7250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME180907
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: