Doctor Name: | RAFAEL OSVALDO HERNANDEZ LORA |
NPI Number: | 1689914814 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 8529 Pines Blvd Chen Medical Pembroke Pines, Inc Pembroke Pines, FL - 33024 |
Business Phone Number: | 9547043300 |
Business Fax Number: | 9548002071 |
Mailing Address: | 8529 Pines Blvd, Chen Medical Pembroke Pines, Inc PEMBROKE PINES |
State: | FL |
Postal Code: | 33024 |
Phone Number: | 9547043300 |
Fax Number: | 9548002071 |
NPI Enumeration Date: | 02/25/2013 |
NPI Last Update Date: | 08/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |