Provider Demographics
NPI:1639157258
Name:HERNANDEZ, DINORAH (RPA-C)
Entity Type:Individual
Prefix:
First Name:DINORAH
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 CORPORATE CENTER DR STE 600
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1227
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:305-500-2145
Practice Address - Street 1:442 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6036
Practice Address - Country:US
Practice Address - Phone:305-245-0200
Practice Address - Fax:305-245-6186
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010848363AM0700X, 363A00000X
FLPA9104533363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02730409Medicaid
NY6109L4T771Medicare ID - Type Unspecified
NYQ62714Medicare UPIN