Provider Demographics
NPI:1558488619
Name:HERNANDEZ, ELBA I (RN)
Entity Type:Individual
Prefix:
First Name:ELBA
Middle Name:I
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 E SILVER SPRINGS BLVD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6831
Mailing Address - Country:US
Mailing Address - Phone:352-369-2108
Mailing Address - Fax:
Practice Address - Street 1:1515 E SILVER SPRINGS BLVD
Practice Address - Street 2:SUITE 213
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6831
Practice Address - Country:US
Practice Address - Phone:352-369-2108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2713132163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management