National Provider Identifier
Luis Raul Hernandez III
Luis Raul Hernandez III is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (786) 266-1010.
Profile Overview
- NPI
- 1467121491
- Provider Type
- Individual
- Primary Specialty
- Athletic Trainer
- Enumeration Date
- September 13, 2021
- Last Updated
- September 13, 2021
Practice Location
- 953 Danby RD
- Ithaca, NY 14850-7002
Phone: (786) 266-1010
Mailing Address
- 15100 Sw 128Th Ave
- Miami, FL 33186-6391
Specialties
- Athletic Trainer (2255A2300X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1467121491
- Entity Type
- Individual
- Last Name
- Hernandez
- First Name
- Luis
- Middle Name
- Raul
- Name Suffix
- III
- Mailing Street Address
- 15100 Sw 128Th Ave
- Mailing City
- Miami
- Mailing State
- FL
- Mailing ZIP Code
- 33186-6391
- Mailing Country
- US
- Mailing Phone
- (786) 266-1010
- Practice Street Address
- 953 Danby RD
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-7002
- Practice Country
- US
- Practice Phone
- (786) 266-1010
- Enumeration Date
- September 13, 2021
- Last Updated
- September 13, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 13, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Athletic Trainer (2255A2300X), Student in an Organized Health Care Education/Training Program (390200000X)