Provider Demographics
NPI:1578166286
Name:HERNANDEZ, VALERIE DENISE
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:DENISE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:DENISE
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5903 GRAND LONEOAK LN
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4874
Mailing Address - Country:US
Mailing Address - Phone:813-731-8199
Mailing Address - Fax:
Practice Address - Street 1:5903 GRAND LONEOAK LN
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-4874
Practice Address - Country:US
Practice Address - Phone:813-731-8199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver