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General NPI Number Information
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NPI Number | 1235104167
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Entity Type | Individual
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Provider Name | DR. RICHARD E HERNANDEZ
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 7765 SW 87TH AVE SUITE 105
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City | MIAMI
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State | FL
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Zip | 33173-2596
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Country | US
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Telephone | 305-274-0808
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Fax | 305-274-8311
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Provider Business Mailing Address
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Address Line | PO BOX 560130
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City | MIAMI
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State | FL
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Zip | 33256-0130
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Country | US
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Telephone | 305-360-9244
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Fax | 305-630-9223
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME0043730
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License Number State | FL
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