| Teresita D Hernandez Mdpa | |
|
10710 Sw 34th St Miami FL 33165-3615 | |
| (305) 559-7330 | |
| (305) 223-4767 |
| Full Name | Teresita D Hernandez Mdpa |
|---|---|
| Speciality | Clinic/Center |
| Location | 10710 Sw 34th St, Miami, Florida |
| Authorized Official Name and Position | Teresita D Hernandez (OWNER) |
| Authorized Official Contact | 3055597330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Teresita D Hernandez Mdpa 3400 Sw 107th Ave Miami FL 33165-3633 Ph: (305) 559-7330 | Teresita D Hernandez Mdpa 10710 Sw 34th St Miami FL 33165-3615 Ph: (305) 559-7330 |
| NPI Number | 1730133901 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 10/23/2008 |
| Medicare PECOS PAC ID | 9739102021 |
|---|---|
| Medicare Enrollment ID | O20060112000799 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730133901 | NPI | - | NPPES |
| 274461900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME93489 (Florida) | Primary |
| Provider Name | Teresita D Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962665182 PECOS PAC ID: 4385659036 Enrollment ID: I20060217000388 |
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