Carlos E. Hernandez, M.D.
Individual provider Active NPI Pediatric Emergency Medicine (Pediatrics) Physician · Coral Gables, FL
NPI 1356441307 · NPPES record last updated Apr 10, 2013
Key facts
- NPI
- 1356441307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X
- License
- ME74676 (FL)
- Practice address
- 5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423 - Phone
- (305) 661-1515
- Fax
- (305) 662-3723
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161012002384 | FL | Practitioner - Pediatric Medicine | 7416245105 | Reassigns benefits to 1 organization |
| I20210316002745 | CA | Practitioner - Family Practice | 7416245105 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME74676 | FL | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Monterey County Memorial Hospital | Current |
Accepting new patients | |
| Emergency Pediatric Services, PA | Current |
Accepting new patients | |
| Southern Monterey County Memorial Hospital | Current |
Accepting new patients | |
| Southern Monterey County Memorial Hospital | Current | Accepting new patients | |
| South Miami Hospital Inc | Past | Accepting new patients | |
| Variety Chidren'S Hospital | Past | Accepting new patients | |
| Baptist Hospital of Miami Inc | Past | Accepting new patients |
Locations
467 El Camino Real
Greenfield, CA 93927
Phone (831) 674-0112
210 Canal St
King City, CA 93930
Phone (931) 385-7100
809 Broadway St
Ste D
King City, CA 93930
Phone (831) 386-7437
300 Canal St
King City, CA 93930
Phone (831) 385-6000
2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277
5955 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 662-8668
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JDEGCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | ME74676 | FL | Yes |
Addresses
Primary practice location
5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Mailing address
5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone (305) 661-1515
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 254146701 | Medicaid | FL |
Other providers in Coral Gables, FL
- Abbey Hernandez
- Alexandra Marie Hernandez
- Ana Hernandez
- Arianna Maria Hernandez
- Bernardo Hernandez
- Carolina Milagros Hernandez
- Constance Joelle Hernandez
- Felix Hernandez
- Fernando Hernandez
- Heather J Hernandez
All providers in Coral Gables, FL · Pediatric Emergency Medicine (Pediatrics) Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.