Individual
JOSE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2710 W 10 TH AVE APT 12, HIALEAH, FL 33010
(305) 728-9074
Mailing address
2710 W 10TH AVE APT 12, HIALEAH, FL 33010-1248
(305) 728-9074
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MM26361
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC9062
AHCA
FL
Enumeration date
11/30/2012
Last updated
12/03/2012
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