MEDICARE: JORGE L. 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	207RP1001X	Pulmonary Disease Physician	ME0066300	FL
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME0066300	FL

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
2	ME0066300	OTHER	FL	MEDICAL LICENSE NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538243167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE L. HERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	10101 W COLONIAL DR STE 102
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4213
Country	:	US
Telephone Number	:	407-895-9060
Fax Number	:	407-895-9010

Provider Business Practice Location Address
First Line	:	10101 W COLONIAL DR STE 102
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4213
Country	:	US
Telephone Number	:	407-895-9060
Fax Number	:	407-895-9010

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	06/03/2020

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Directions to “ JORGE L. HERNANDEZ M.D.” Practice Location

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