Organization
PRESTIGE MEDICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUMBERTO HERNANDEZ (PRESIDENT)
(305) 553-5600
Entity
Organization
Contact information
Practice address
12905 SW 42ND ST STE 101, MIAMI, FL 33175-2910
(305) 553-5600
(305) 553-5602
Mailing address
12905 SW 42ND ST STE 101, MIAMI, FL 33175-2910
(305) 553-5600
(305) 553-5602
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
HCC9068
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FC741A
MEDICARE PROVIDER
FL
Enumeration date
03/23/2011
Last updated
08/16/2012
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