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General NPI Number Information
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NPI Number | 1336298892
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Entity Type | Individual
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Provider Name | CECILIO HERNANDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 4102 N MACDILL AVE
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City | TAMPA
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State | FL
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Zip | 33607-6717
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Country | US
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Telephone | 813-657-0027
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Fax | 813-877-1609
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Provider Business Mailing Address
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Address Line | 4102 N MACDILL AVE
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City | TAMPA
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State | FL
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Zip | 33607-6717
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Country | US
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Telephone | 813-870-3979
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Fax | 813-877-1609
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME68187
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License Number State | FL
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