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Organization
HERNANDEZ MEDICAL GROUP LLC
Active
Organization
HERNANDEZ MEDICAL GROUP LLC
Active
Other names
Hernandez Medical Group LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUEL HERNANDEZ DO (MEDICAL DOCTOR)
(305) 900-8170
Entity
Organization
Contact information
Practice address
2001 W 68TH ST, HIALEAH, FL 33016-1801
(305) 823-5000
Mailing address
165 CAMERON DR, WESTON, FL 33326-3514
(305) 900-8170
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS12178
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012315900
—
FL
01
—
1134418668
NPI INDIVIDUAL
FL
Enumeration date
09/19/2017
Last updated
09/19/2017
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