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General NPI Number Information
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NPI Number | 1649237116
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Entity Type | Organization
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Legal Business Name | HERNANDEZ CHIROPRACTIC INC
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 125 S STATE ROAD 7 SUITE 103
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City | WELLINGTON
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State | FL
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Zip | 33414-4395
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Country | US
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Telephone | 561-792-4016
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Fax | 561-792-4162
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Provider Business Mailing Address
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Address Line | 125 S STATE ROAD 7 SUITE 103
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City | WELLINGTON
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State | FL
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Zip | 33414-4395
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Country | US
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Telephone | 561-792-4016
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Fax | 561-792-4162
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANDRA E HERNANDEZ
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Credential | DC
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Telephone | 561-792-4016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH0006799
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License Number State | FL
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