MEDICARE: ILIANA 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	ME80606	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

General Provider Information

NPI Number	:	1649371766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILIANA HERNANDEZ M.D

Provider Business Mailing Address
First Line	:	13274 SW 13TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-1906
Country	:	US
Telephone Number	:	786-234-8724
Fax Number	:

Provider Business Practice Location Address
First Line	:	1645 NE 8TH ST
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33033-4712
Country	:	US
Telephone Number	:	305-248-7474
Fax Number	:	305-242-4344

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	12/15/2010

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Directions to “ ILIANA HERNANDEZ M.D” Practice Location

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