Provider Demographics
NPI:1275111734
Name:HERNANDEZ, PAOLA ANDREA (APRN)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:ANDREA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:PAOLA
Other - Middle Name:
Other - Last Name:DICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8245 BALM ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34607
Mailing Address - Country:US
Mailing Address - Phone:352-688-2700
Mailing Address - Fax:352-688-0300
Practice Address - Street 1:8245 BALM ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34607
Practice Address - Country:US
Practice Address - Phone:352-688-2700
Practice Address - Fax:352-688-0300
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007372363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner