Individual
RAUL HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(954) 232-3643
Mailing address
1301 BRISTOL AVE, DAVIE, FL 33325-6510
(954) 232-3643
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
017968
ME
207P00000X
Emergency Medicine Physician
Primary
44108
KY
207P00000X
Emergency Medicine Physician
ME0043960
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040691100
—
FL
01
—
96707
BCBS
FL
Enumeration date
08/23/2005
Last updated
04/03/2015
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