Organization
LAUREATE MEDICAL GROUP AT NORTHSIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE J HERNANDEZ (VP ADMIN/CCO)
(404) 851-6378
Entity
Organization
Contact information
Practice address
1110 W PEACHTREE ST NW STE 1100, ATLANTA, GA 30309-3609
(404) 892-2131
(404) 215-9222
Mailing address
1110 W PEACHTREE ST NW STE 1100, ATLANTA, GA 30309-3609
(404) 892-2131
(404) 215-9222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/07/2007
Last updated
06/02/2025
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