Provider Demographics
NPI:1396383998
Name:HERNANDEZ, IVETTE LUCIA (APRN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:IVETTE
Middle Name:LUCIA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7918 W HILLSBOROUGH AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4608
Mailing Address - Country:US
Mailing Address - Phone:813-374-2444
Mailing Address - Fax:813-644-7040
Practice Address - Street 1:7918 W HILLSBOROUGH AVENUE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4608
Practice Address - Country:US
Practice Address - Phone:813-374-2444
Practice Address - Fax:813-644-7040
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily