Provider Demographics
NPI:1710522503
Name:HERNANDEZ, BEATRIZ ELIZABETH
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:ELIZABETH
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 1:523 ROUND TABLE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5640
Mailing Address - Country:US
Mailing Address - Phone:301-357-3050
Mailing Address - Fax:
Practice Address - Street 1:3232 GEORGIA AVE NW APT 206
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3085
Practice Address - Country:US
Practice Address - Phone:202-413-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCH6550851610023747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant