Individual
MICHAEL HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9680 W NORTHERN AVE UNIT 1107, PEORIA, AZ 85345-4641
(602) 309-6205
Mailing address
9680 W NORTHERN AVE UNIT 1107, PEORIA, AZ 85345-4641
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1850207
AZ
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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