MEDICARE: DR. JOSE ROBERTO HERNANDEZ JR. R EDT

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	246ZE0600X	Electroneurodiagnostic Specialist/Technologist	561
2	247100000X	Radiologic Technologist	57895	FL

General Provider Information

NPI Number	:	1922040898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE ROBERTO HERNANDEZ JR. R EDT

Provider Business Mailing Address
First Line	:	14700 SW 57TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33193-2499
Country	:	US
Telephone Number	:	305-383-5846
Fax Number	:

Provider Business Practice Location Address
First Line	:	9788 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-7574
Country	:	US
Telephone Number	:	305-223-0224
Fax Number	:	305-223-4001

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	09/11/2025

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Directions to “ DR. JOSE ROBERTO HERNANDEZ JR. R EDT” Practice Location

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