Healthcare Provider Details

I. General information

NPI: 1073620498
Provider Name (Legal Business Name): CHILDREN'S INTERNATIONAL L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 LINDBERG DR
SLIDELL LA
70458-8056
US

IV. Provider business mailing address

1430 LINDBERG DR
SLIDELL LA
70458-8056
US

V. Phone/Fax

Practice location:
  • Phone: 985-781-7337
  • Fax: 985-781-7339
Mailing address:
  • Phone: 985-781-7337
  • Fax: 985-781-7339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDUARDO J. HERNANDEZ
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: M.D.
Phone: 985-781-7337