Provider Demographics
NPI:1073227799
Name:HERNANDEZ RODRIGUEZ, MIRTHA DEL PILAR (ARNP)
Entity Type:Individual
Prefix:
First Name:MIRTHA
Middle Name:DEL PILAR
Last Name:HERNANDEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 WOODBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1900
Mailing Address - Country:US
Mailing Address - Phone:813-802-4316
Mailing Address - Fax:
Practice Address - Street 1:9507 WOODBOROUGH CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1900
Practice Address - Country:US
Practice Address - Phone:813-802-4316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner