Provider Demographics
NPI:1265123517
Name:HERNANDEZ, ISABEL MARIA
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:MARIA
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 1:9066 SW 73RD CT APT 2104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2971
Mailing Address - Country:US
Mailing Address - Phone:305-972-2093
Mailing Address - Fax:
Practice Address - Street 1:1150 NW 14TH ST STE 508
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-2116
Practice Address - Country:US
Practice Address - Phone:305-243-5509
Practice Address - Fax:305-243-5595
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026341363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily