Doctor Name: | DR. MANNY J HERNANDEZ |
NPI Number: | 1548348725 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME0041260 |
Business Practice Address: | 1255 1 Viscaya Parkway Suite 103 Cape Coral, FL - 33990 |
Business Phone Number: | 2395736111 |
Business Fax Number: | 2395739534 |
Mailing Address: | 1255 1 Viscaya Parkway, Suite 103 CAPE CORAL |
State: | FL |
Postal Code: | 33990 |
Phone Number: | 2395736111 |
Fax Number: | 2395739534 |
NPI Enumeration Date: | 11/02/2006 |
NPI Last Update Date: | 10/03/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME0041260 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |