Provider Demographics
NPI:1245060797
Name:HERNANDEZ HERNANDEZ, YAIDELYS
Entity type:Individual
Prefix:
First Name:YAIDELYS
Middle Name:
Last Name:HERNANDEZ 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 1:4793 CHARIOT CIR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-5316
Mailing Address - Country:US
Mailing Address - Phone:561-298-7202
Mailing Address - Fax:
Practice Address - Street 1:4793 CHARIOT CIR
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-5316
Practice Address - Country:US
Practice Address - Phone:561-298-7202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide