Provider Demographics
NPI:1649057852
Name:HERNANDEZ, LINAMARIE VITA (CNA)
Entity type:Individual
Prefix:
First Name:LINAMARIE
Middle Name:VITA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16194 75TH PL N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-1928
Mailing Address - Country:US
Mailing Address - Phone:305-900-3709
Mailing Address - Fax:
Practice Address - Street 1:16194 75TH PL N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-1928
Practice Address - Country:US
Practice Address - Phone:305-900-3709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA440935376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide