Basic Information
| Provider Information | |||||||||
| NPI: | 1568497485 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HERNANDEZ-RIOS | ||||||||
| FirstName: | PEDRO | ||||||||
| MiddleName: | JORGE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HERNANDEZ | ||||||||
| OtherFirstName: | PEDRO | ||||||||
| OtherMiddleName: | JORGE | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD MPH | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 9960 CENTRAL PARK BLVD N | ||||||||
| Address2: | SUITE 450 | ||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334281759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613531225 | ||||||||
| FaxNumber: | 5613531226 | ||||||||
| Practice Location | |||||||||
| Address1: | 23123 STATE ROAD 7 | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334285489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618526500 | ||||||||
| FaxNumber: | 5618526502 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 05/10/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | ME0066967 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.