Provider Demographics
NPI:1346845161
Name:HERNANDEZ-FERNANDEZ, MADAY (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MADAY
Middle Name:
Last Name:HERNANDEZ-FERNANDEZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 12TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-3334
Mailing Address - Country:US
Mailing Address - Phone:305-343-7833
Mailing Address - Fax:
Practice Address - Street 1:1102 N 15TH ST
Practice Address - Street 2:
Practice Address - City:IMMOKALEE
Practice Address - State:FL
Practice Address - Zip Code:34142-2813
Practice Address - Country:US
Practice Address - Phone:239-657-3188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS453751835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy