Provider Demographics
NPI:1871513390
Name:ROBERTO A. HERNANDO MD PA
Entity type:Organization
Organization Name:ROBERTO A. HERNANDO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:HERNANDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-274-9206
Mailing Address - Street 1:9350 SUNSET DRIVE
Mailing Address - Street 2:SUITE 151
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3286
Mailing Address - Country:US
Mailing Address - Phone:305-274-9206
Mailing Address - Fax:305-274-9254
Practice Address - Street 1:9350 SUNSET DRIVE
Practice Address - Street 2:SUITE 151
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3286
Practice Address - Country:US
Practice Address - Phone:305-274-9206
Practice Address - Fax:305-274-9254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014767300Medicaid
FL267168900Medicaid
FL267168900Medicaid