Provider Demographics
NPI:1467189696
Name:DE LOS SANTOS HERNANDEZ, HECTOR JULIO (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:JULIO
Last Name:DE LOS SANTOS HERNANDEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 53RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-4249
Mailing Address - Country:US
Mailing Address - Phone:941-357-7950
Mailing Address - Fax:941-840-1003
Practice Address - Street 1:1505 53RD AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-4249
Practice Address - Country:US
Practice Address - Phone:941-357-7950
Practice Address - Fax:941-840-1003
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME171361207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty