Individual
MR. JUAN CARLOS HERNANDEZ PRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-2720
Mailing address
215 E 95TH ST, 24E, NEW YORK, NY 10128-4077
(646) 469-5582
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
280085
NY
207ZP0101X
Anatomic Pathology Physician
Primary
ME130418
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/25/2011
Last updated
11/17/2016
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