Provider Demographics
NPI:1285728840
Name:HERNANDEZ, YAMIR
Entity type:Individual
Prefix:
First Name:YAMIR
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 GRAND CANAL DR
Mailing Address - Street 2:STE.# 401
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2561
Mailing Address - Country:US
Mailing Address - Phone:305-773-6562
Mailing Address - Fax:
Practice Address - Street 1:85 GRAND CANAL DR
Practice Address - Street 2:STE.# 401
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2561
Practice Address - Country:US
Practice Address - Phone:305-262-6158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL628962471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography