Healthcare Provider Details

I. General information

NPI: 1831007640
Provider Name (Legal Business Name): DR. JULIO GABRIEL HERNANDEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4740 CHERRY HILL RD
COLLEGE PARK MD
20740-1330
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 1600 STE 1600
DOWNERS GROVE IL
60515-1211
US

V. Phone/Fax

Practice location:
  • Phone: 240-965-0999
  • Fax:
Mailing address:
  • Phone: 630-296-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15610
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: