Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME-41627 | FL |
NPI | 1053378893 |
---|---|
Provider Name | Dr. Hernan R Baquerizo |
First Address | Miami, FL 33133-4200 |
Second Address | Miami, FL 33133-4200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 20/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2632209-00 | (05) | FL |
AB2507551 | DEA (01) | FL |
E65712 | (02) | |
ME-41627 | MEDICAL LICENSE (01) | FL |