Provider Demographics
NPI:1790206381
Name:HERNANDEZ, ANDRES FELIPE (CAA)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:FELIPE
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:CAA
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Mailing Address - Street 1:1090 DE LEON DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30021-1028
Mailing Address - Country:US
Mailing Address - Phone:954-260-6011
Mailing Address - Fax:
Practice Address - Street 1:80 JESSE HILL JR DR SE STE 6D028
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3031
Practice Address - Country:US
Practice Address - Phone:404-616-8760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant