MEDICARE: DR. EUGENIO J 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	207RG0100X	Gastroenterology Physician	ME70525	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790887313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENIO J HERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	8950 N KENDALL DR STE 306
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2131
Country	:	US
Telephone Number	:	305-596-9966
Fax Number	:	305-596-5752

Provider Business Practice Location Address
First Line	:	8950 N KENDALL DR STE 306
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2131
Country	:	US
Telephone Number	:	305-596-9966
Fax Number	:	305-596-5752

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

Provider Enumeration Date	:	09/03/2006
Last Update Date	:	05/11/2022

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