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NPI Code Detail

MEDICARE: MR. RAFAEL HERNANDO HERNANDEZ

MEDICARE:  MR. RAFAEL HERNANDO HERNANDEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA28715FL

General Provider Information

NPI Number : 1073096822
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RAFAEL HERNANDO HERNANDEZ
Provider Business Mailing Address
First Line : 999 NIGHTINGALE AVE
Second Line :
City : MIAMI SPRINGS
State : FL
Zip : 33166-3826
Country : US
Telephone Number : 305-965-4900
Fax Number :
Provider Business Practice Location Address
First Line : 999 NIGHTINGALE AVE
Second Line :
City : MIAMI SPRINGS
State : FL
Zip : 33166-3826
Country : US
Telephone Number : 305-965-4900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2018
Last Update Date : 09/07/2018

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Directions to “ MR. RAFAEL HERNANDO HERNANDEZ ” Practice Location

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