Manuel H Hernandez M D P a

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0076069 Issued in FL

Legal business name

MANUEL H HERNANDEZ M D P A

Practice address

4235 Kings Hwy
Suite 101
Punta Gorda, FL 33980-8415

Phone

(941) 764-7773

Fax

(941) 764-7681

NPI assigned

Mar 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Manuel Hernandez, M.D.NPI 1609990605

Title

President

Phone

(941) 764-7773

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manuel Hector Hernandez, M.D.

  • Dermatology Physician
  • Port Charlotte, FL
  • NPI 1609990605
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1316064231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 KINGS HWY UNIT 101",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339808421",
            "telephone_number": "941-764-7773",
            "fax_number": "941-764-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 KINGS HWY",
            "address_2": "SUITE 101",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339808415",
            "telephone_number": "941-764-7773",
            "fax_number": "941-764-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL H HERNANDEZ M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-24",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-764-7773",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "0076069",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "0076069",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "FL",
            "license": "0076069",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "FL",
            "license": "0076069",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "0076069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph J Maggiore, D.D.S.
• Sandra Mahoney, PT
• Hannah Marie Manczka, MS, OTR/L
• Sukdai Mangru, CNM
• Manila Physical Therapy , Inc
• Sammy Dallas Maples, PHARMD
• Maide Marcel
• Melissa Marino, DMD
• Mark C Droffner
• Michael Robert Markgraf, DDS

• Dermatology Physician in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.