Organization
INSTITUTE OF PREVENTIVE MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OTNIEL HERNANDEZ DNP (CEO)
(305) 676-2300
Entity
Organization
Contact information
Practice address
1275 W 47TH PL, SUITE 422, HIALEAH, FL 33012-3394
(305) 676-2300
(888) 601-0076
Mailing address
1275 W 47TH PL, SUITE 422, HIALEAH, FL 33012-3394
(305) 676-2300
(888) 601-0076
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ARNP3081082
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308614300
—
FL
Enumeration date
03/29/2011
Last updated
05/03/2017
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