Hernandez, Mark Antonio

Hernandez, Mark Antonio is an sole proprietor health care provider with primary practice located at 2387 W 68Th St Suite 303, Hialeah FL 33016-6889. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Psychiatry, which is considered as his primary health care specialty. Hernandez, Mark Antonio can be contacted via phone (954) 792-0400.

Contact Information

Primary practice address
2387 W 68Th St Suite 303 Hialeah FL 33016-6889
Phone: (954) 792-0400
Fax: (305) 598-6536
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X ME83014 Florida

Profile Details

NPI number 1477627602
LBN Legal business name Hernandez, Mark Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2006
Last updated Apr 3rd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477627602 NPPES
Florida MEDICAID 268434900

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