MEDICARE: ROBERT J HERNANDEZ MD

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	207RI0200X	Infectious Disease Physician	ME93278	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	29304X	OTHER	FL	MEDICARE PTAN

General Provider Information

NPI Number	:	1558303701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT J HERNANDEZ MD

Provider Business Mailing Address
First Line	:	15421 SW 82ND AVE
Second Line	:
City	:	VILLAGE OF PALMETTO BAY
State	:	FL
Zip	:	33157-2215
Country	:	US
Telephone Number	:	786-348-5921
Fax Number	:	305-271-2412

Provider Business Practice Location Address
First Line	:	9240 SW 72ND ST
Second Line	:	SUITE 241
City	:	MIAMI
State	:	FL
Zip	:	33173-3261
Country	:	US
Telephone Number	:	305-271-1919
Fax Number	:	305-271-1911

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	06/08/2020

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Directions to “ ROBERT J HERNANDEZ MD” Practice Location

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