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NPI Code Detail

MEDICARE: MARK A HERNANDEZ MD

MEDICARE: MARK A 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
1208M00000XHospitalist PhysicianME84218FL
2207R00000XInternal Medicine PhysicianME84218FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00191950OTHERFLRARILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3N220840OTHERFLWELLCARE
413085OTHERFLBCBS

General Provider Information

NPI Number : 1881679421
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK A HERNANDEZ MD
Provider Business Mailing Address
First Line : PO BOX 165154
Second Line :
City : MIAMI
State : FL
Zip : 33116-5154
Country : US
Telephone Number : 786-882-1919
Fax Number : 786-206-3161
Provider Business Practice Location Address
First Line : 9619 S DIXIE HWY
Second Line :
City : PINECREST
State : FL
Zip : 33156-2804
Country : US
Telephone Number : 786-882-1919
Fax Number : 786-206-3161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 11/05/2024

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