Most Relevant Information
Provider Data
| NPI Number: | 1003285842 |
| Provider Name: | IVAN HERNANDEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | PS53984 |
Most Important Dates
| Enumeration Date: | 09/23/2015 |
| Last Updated: | 09/23/2015 |
Provider Practice Location
1500 S DOUGLAS RD
CORAL GABLES
FL
331344108
Practice Location Phone/Fax
| Phone: | 3054453252 |
| Fax: |
Provider Mailing Location
1500 S DOUGLAS RD
CORAL GABLES
FL
331344108
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |