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General NPI Number Information
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NPI Number | 1346486552
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Entity Type | Organization
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Legal Business Name | HECTOR N. HERNANDEZ, M.D., P.A.
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 06/03/2009
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Provider Practice Location Address
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Address Line | 21297A OLEAN BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6704
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Country | US
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Telephone | 941-764-0660
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 510429
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City | PUNTA GORDA
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State | FL
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Zip | 33951-0429
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Country | US
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Telephone | 941-764-0660
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HECTOR NICOLAS HERNANDEZ
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Credential | M.D.
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Telephone | 941-764-0660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME-67993
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License Number State | FL
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