| Hernandez Medical Group Llc | |
|
2001 W 68th St Hialeah FL 33016-1801 | |
| (305) 823-5000 | |
| Not Available |
| Full Name | Hernandez Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2001 W 68th St, Hialeah, Florida |
| Authorized Official Name and Position | Emmanuel Hernandez (MEDICAL DOCTOR) |
| Authorized Official Contact | 3059008170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hernandez Medical Group Llc 165 Cameron Dr Weston FL 33326-3514 Ph: (305) 900-8170 | Hernandez Medical Group Llc 2001 W 68th St Hialeah FL 33016-1801 Ph: (305) 823-5000 |
| NPI Number | 1669991873 |
|---|---|
| Provider Enumeration Date | 09/19/2017 |
| Last Update Date | 09/19/2017 |
| Medicare PECOS PAC ID | 8820344492 |
|---|---|
| Medicare Enrollment ID | O20180712000593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669991873 | NPI | - | NPPES |
| 1134418668 | Other | FL | NPI INDIVIDUAL |
| 012315900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS12178 (Florida) | Primary |
| Provider Name | Emmanuel Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134418668 PECOS PAC ID: 1951525427 Enrollment ID: I20140624001845 |
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