Individual
MARK ANTONIO HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2387 W 68TH ST, SUITE 303, HIALEAH, FL 33016-6889
(954) 792-0400
(305) 598-6536
Mailing address
12355 SW 76 ST, MIAMI, FL 33183
(786) 282-8983
(305) 598-6536
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
ME83014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268434900
—
FL
Enumeration date
11/20/2006
Last updated
04/03/2014
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