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General NPI Number Information
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NPI Number | 1922817519
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Entity Type | Individual
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Provider Name | ENRIQUE JAVIER HERNANDEZ RPH
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Gender | Male
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 4613 N UNIVERSITY DR # 142
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4602
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Country | US
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Telephone | 561-400-1824
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 FORSYTH BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63105-1813
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Country | US
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Telephone | 314-725-4477
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS28016
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License Number State | FL
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