Individual
LUIS RAUL HERNANDEZ III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
953 DANBY RD, ITHACA, NY 14850-7002
(786) 266-1010
Mailing address
15100 SW 128TH AVE, MIAMI, FL 33186-6391
(786) 266-1010
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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