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General NPI Number Information
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NPI Number | 1093708331
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Entity Type | Individual
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Provider Name | RAUL HERNANDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 900 HOSPITAL DR
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City | MADISONVILLE
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State | KY
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Zip | 42431-1644
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Country | US
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Telephone | 954-232-3643
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 BRISTOL AVE
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City | DAVIE
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State | FL
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Zip | 33325-6510
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Country | US
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Telephone | 954-232-3643
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 017968
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME0043960
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 44108
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License Number State | KY
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