Provider Demographics
NPI:1609504893
Name:HERNANDEZ, CATHERINE JONINA (DNP, APRN, CPNP-PC)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:JONINA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12136 COBBLE STONE DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-2432
Mailing Address - Country:US
Mailing Address - Phone:727-863-5474
Mailing Address - Fax:
Practice Address - Street 1:12136 COBBLE STONE DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-2432
Practice Address - Country:US
Practice Address - Phone:727-863-5474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011101363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115395300Medicaid