Individual
DR. CONRAD HERNANDEZ VINALON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 10TH ST N STE 1E, ST PETERSBURG, FL 33705-1407
(727) 824-3120
(727) 824-8313
Mailing address
620 10TH ST N STE 1E, ST PETERSBURG, FL 33705-1407
(727) 824-3120
(727) 824-8313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME121005
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017877400
—
FL
01
—
P01727389
RAILROAD MEDICARE PTAN
FL
Enumeration date
05/23/2013
Last updated
03/28/2022
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