Individual
SERGIO ROQUE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
5407 TUPELO PASS, LOUISVILLE, KY 40213-2961
(786) 296-2018
Mailing address
5407 TUPELO PASS, LOUISVILLE, KY 40213-2961
(786) 296-2018
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1168915
KY
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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