Provider Demographics
NPI:1518986975
Name:HERNANDEZ, ANA VICTORIA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:VICTORIA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16201 NW 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6709
Mailing Address - Country:US
Mailing Address - Phone:305-628-2808
Mailing Address - Fax:305-623-2994
Practice Address - Street 1:16201 NW 57TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-6709
Practice Address - Country:US
Practice Address - Phone:305-628-2808
Practice Address - Fax:305-623-2994
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL 3548152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist