MEDICARE: LILIAM HERNANDEZ M.D

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
1	207Q00000X	Family Medicine Physician	26392	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194913806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIAM HERNANDEZ M.D

Provider Business Mailing Address
First Line	:	19177 S DIXIE HWY
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7714
Country	:	US
Telephone Number	:	239-789-8101
Fax Number	:

Provider Business Practice Location Address
First Line	:	19177 S DIXIE HWY
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7714
Country	:	US
Telephone Number	:	239-789-8101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	06/12/2015

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Directions to “ LILIAM HERNANDEZ M.D” Practice Location

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