MEDICARE: MR. ENRIQUE A HERNANDEZ VILA 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	207RI0011X	Interventional Cardiology Physician	ME126765	FL
2	2085R0204X	Vascular & Interventional Radiology Physician	ME126765	FL

General Provider Information

NPI Number	:	1700044617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ENRIQUE A HERNANDEZ VILA MD

Provider Business Mailing Address
First Line	:	7480 BIRD RD STE 560
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-6657
Country	:	US
Telephone Number	:	305-707-5688
Fax Number	:	305-760-4149

Provider Business Practice Location Address
First Line	:	7480 BIRD RD STE 560
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-6657
Country	:	US
Telephone Number	:	305-707-5688
Fax Number	:	305-760-4149

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

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	02/18/2024

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