Basic Information
| Provider Information | |||||||||
| NPI: | 1306228655 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VARELA | ||||||||
| FirstName: | HERNAN | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VARELA-JERALDO | ||||||||
| OtherFirstName: | HERNAN | ||||||||
| OtherMiddleName: | J. | ||||||||
| OtherNamePrefix: | MR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6280 W SAMPLE RD STE 202 | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330673173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613223588 | ||||||||
| FaxNumber: | 5613223589 | ||||||||
| Practice Location | |||||||||
| Address1: | 1097 SW LEJEUNE ROAD | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054422020 | ||||||||
| FaxNumber: | 3054227354 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2015 | ||||||||
| LastUpdateDate: | 11/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | ACN1079 | FL | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.