Provider Demographics
NPI:1558539312
Name:HERNANDEZ, CIRIA
Entity Type:Individual
Prefix:MS
First Name:CIRIA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18960 NW 57TH AVE
Mailing Address - Street 2:#205
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-7071
Mailing Address - Country:US
Mailing Address - Phone:786-597-1108
Mailing Address - Fax:305-454-0372
Practice Address - Street 1:18960 NW 57TH AVE
Practice Address - Street 2:#205
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-7071
Practice Address - Country:US
Practice Address - Phone:786-597-1108
Practice Address - Fax:305-454-0372
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230234372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty