Individual
DR. JORGE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
160 NW 13TH ST, HOMESTEAD, FL 33030-4228
(786) 596-6557
Mailing address
255 W. MICHIGAN AVE, JACKSON, MI 49201-1909
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME 83597
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050089347
RAILROAD
—
05
—
263648400
—
FL
01
—
51960
BLUE SHIELD
FL
Enumeration date
07/24/2006
Last updated
06/24/2010
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