Provider Demographics
NPI:1255871000
Name:HERNANDEZ, CRISTIAN (DC)
Entity type:Individual
Prefix:DR
First Name:CRISTIAN
Middle Name:
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 1:19451 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33332-1653
Mailing Address - Country:US
Mailing Address - Phone:954-842-2384
Mailing Address - Fax:954-589-0636
Practice Address - Street 1:19451 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33332-1653
Practice Address - Country:US
Practice Address - Phone:954-638-2785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor