Active NPI
Celso Roman Hernandez, MD
- Family Medicine Physician
- Tavernier, FL
National Provider Identifier
1063588820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME28458
- Practice address
- 92140 Overseas Hwy
Suite 2
Tavernier, FL 33070-2636 - Phone
- (305) 852-7473
- Fax
- (305) 852-8962
- NPI assigned
- Nov 24, 2006
- Last updated
- Feb 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME28458 | FL | Primary |
Addresses
Primary practice location
92140 Overseas Hwy
Suite 2
Tavernier, FL 33070-2636
Mailing address
92140 Overseas Hwy
Suite 2
Tavernier, FL 33070-2636
Phone (305) 852-7473
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 057246202 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264982400000",
"number": "1063588820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92140 OVERSEAS HWY",
"address_2": "SUITE 2",
"city": "TAVERNIER",
"state": "FL",
"postal_code": "330702636",
"telephone_number": "305-852-7473",
"fax_number": "305-852-8962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92140 OVERSEAS HWY",
"address_2": "SUITE 2",
"city": "TAVERNIER",
"state": "FL",
"postal_code": "330702636",
"telephone_number": "305-852-7473",
"fax_number": "305-852-8962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "CELSO",
"middle_name": "ROMAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-24",
"last_updated": "2010-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME28458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "057246202",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tavernier, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.