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General NPI Number Information
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NPI Number | 1699056556
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Entity Type | Individual
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Provider Name | GISELLE MARIE HERNANDEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 9333 SW 152ND ST
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1778
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Country | US
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Telephone | 305-251-2500
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Fax | 478-633-8698
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Provider Business Mailing Address
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Address Line | 1611 NW 12TH AVE # 303
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-243-3000
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Fax | 305-324-7658
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME137259
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License Number State | FL
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