Doctor Name: | MICHAEL HERNANDEZ |
NPI Number: | 1043610330 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | CPOA0285 |
Business Practice Address: | 971 Maple Creek Dr Slidell, LA - 704615341 |
Business Phone Number: | 9857108236 |
Business Fax Number: | |
Mailing Address: | 971 Maple Creek Dr, SLIDELL |
State: | LA |
Postal Code: | 704615341 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/25/2014 |
NPI Last Update Date: | 08/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246Z00000X |
License Number: | CPOA0285 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | |
Taxonomy Definition: | General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |