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General NPI Number Information
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NPI Number | 1649371766
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Entity Type | Individual
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Provider Name | ILIANA HERNANDEZ M.D
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 1645 NE 8TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-4712
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Country | US
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Telephone | 305-248-7474
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Fax | 305-242-4344
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Provider Business Mailing Address
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Address Line | 13274 SW 13TH ST
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City | MIAMI
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State | FL
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Zip | 33184-1906
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Country | US
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Telephone | 786-234-8724
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME80606
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License Number State | FL
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