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Individual

DR. RICHARD W HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
36021 US HIGHWAY 19 N, PALM HARBOR, FL 34684-1531
(727) 772-1000
(727) 771-0770
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2603
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
086946501
FL
Enumeration date
08/03/2005
Last updated
12/20/2021
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