Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | M-13146 | ID |
N | 207RN0300X | Nephrologist | MD.MD.60524035 | WA |
Y | 207RN0300X | Nephrologist | ME 124673 | FL |
NPI | 1033489711 |
---|---|
Provider Name | Dr. Marcos Antonio Hernandez Roman |
First Address | Miami, FL 33133-6311 |
Second Address | Miami, FL 33165-3619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2012 |
Last Update Date | 02/09/2016 |