Provider Demographics
NPI:1043305634
Name:HERNANDEZ, ANA L (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:L
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 8TH AVE W
Mailing Address - Street 2:STE 101
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4737
Mailing Address - Country:US
Mailing Address - Phone:941-776-4008
Mailing Address - Fax:941-845-4963
Practice Address - Street 1:250 N BREVARD AVE STE 2
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266
Practice Address - Country:US
Practice Address - Phone:863-494-4433
Practice Address - Fax:863-494-4005
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2017-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME61296208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374099400Medicaid
FLD59841Medicare UPIN