Organization Active NPI

Mauricio Hernandez Mdpa

  • Specialist
  • Miami, FL
National Provider Identifier
1316247679
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MAURICIO HERNANDEZ MDPA
Practice address
11760 SW 40TH St
Suite 635
Miami, FL 33175-3582
Phone
(305) 220-2121
NPI assigned
Nov 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Dr. Mauricio Hernandez, MDNPI 1467436501
Title
President
Phone
(305) 220-2121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

11760 SW 40TH St
Suite 635
Miami, FL 33175-3582

Mailing address

PO Box 830635
Miami, FL 33283-0635
Phone (305) 220-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110609000634 FL Part B Supplier - Clinic/Group Practice 6002093598 Receives reassigned benefits from 1 practitioner
Practice locations: Hialeah, FL; Miami, FL

National Provider Directory

National Provider Directory

Locations

777 E 25th St
Ste 509
Hialeah, FL 33013
Phone (305) 420-5016

11760 SW 40th St
Ste 635
Miami, FL 33175
Phone (305) 220-2121

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1316247679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830635",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332830635",
            "telephone_number": "305-220-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 SW 40TH ST",
            "address_2": "SUITE 635",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753582",
            "telephone_number": "305-220-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURICIO HERNANDEZ MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "MAURICIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-220-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.