Provider Demographics
NPI:1962927186
Name:HERNANDEZ, MANUEL ENRIQUE (DC)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:ENRIQUE
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HEMLOCK CIRCLE CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-9092
Mailing Address - Country:US
Mailing Address - Phone:352-362-5980
Mailing Address - Fax:
Practice Address - Street 1:3773 S PINE AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6608
Practice Address - Country:US
Practice Address - Phone:352-369-6325
Practice Address - Fax:352-369-6329
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor