Individual
DR. MANNY J HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 1 VISCAYA PARKWAY, SUITE 103, CAPE CORAL, FL 33990
(239) 573-6111
(239) 573-9534
Mailing address
1255 1 VISCAYA PARKWAY, SUITE 103, CAPE CORAL, FL 33990
(239) 573-6111
(239) 573-9534
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME0041260
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96487
BCBS
—
Enumeration date
11/02/2006
Last updated
10/03/2007
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