Rafael Hernandez Jr.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

ME83014 Issued in FL

Practice address

10570 S US Highway 1
Suite 102
Port Saint Lucie, FL 34952-5606

Phone

(772) 828-6992

NPI assigned

Oct 7, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Palms Wellness Center

  • Addiction Medicine (Family Medicine) Physician
  • Port Saint Lucie, FL
  • NPI 1144770686

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1417407958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10570 S US HIGHWAY 1",
            "address_2": "SUITE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525606",
            "telephone_number": "772-828-6992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10570 S US HIGHWAY 1",
            "address_2": "SUITE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525606",
            "telephone_number": "772-828-6992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "RAFAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME83014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lissy Hernandez Rodriguez
• Tamara Hernandez Rodriguez, APRN
• Angelica M. Hernandez, BA
• Emily Hernandez
• Idaymi Hernandez
• Sahyly Hernandez, DO
• Tyeesha Herndon, B.S.,M.A.
• Geysy Herrera Santiago, BACB 1049856
• Yoslaima Herrera Valdes
• Reinelis Herrera, RBT

• Addiction Medicine (Family Medicine) Physician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Addiction Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.