Provider Demographics
NPI:1003262825
Name:HERNANDEZ ZAS, RAIMUNDO (ARNP)
Entity Type:Individual
Prefix:
First Name:RAIMUNDO
Middle Name:
Last Name:HERNANDEZ ZAS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 WEYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-2252
Mailing Address - Country:US
Mailing Address - Phone:786-277-7096
Mailing Address - Fax:
Practice Address - Street 1:4610 WEYMOUTH ST
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-2252
Practice Address - Country:US
Practice Address - Phone:786-277-7096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9321219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily