Provider Demographics
NPI:1821513714
Name:HERNANDEZ, ANIHARA (RPH)
Entity Type:Individual
Prefix:
First Name:ANIHARA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6371 MOSELEY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-4106
Mailing Address - Country:US
Mailing Address - Phone:954-401-1027
Mailing Address - Fax:
Practice Address - Street 1:5211 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3344
Practice Address - Country:US
Practice Address - Phone:954-987-6802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist