Individual
EDISON HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4774 AUGUSTA AVE, OLDSMAR, FL 34677-6304
(727) 798-6395
Mailing address
4774 AUGUSTA AVE, OLDSMAR, FL 34677-6304
(727) 798-6395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 9050
FL
Other
Enumeration date
10/10/2007
Last updated
10/10/2007
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