Provider Demographics
NPI:1831865401
Name:HERNANDEZ, ADHARA MERCEDES (PA-C)
Entity type:Individual
Prefix:
First Name:ADHARA
Middle Name:MERCEDES
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 260133
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-7133
Mailing Address - Country:US
Mailing Address - Phone:954-593-2733
Mailing Address - Fax:
Practice Address - Street 1:11265 SW 17TH CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-6601
Practice Address - Country:US
Practice Address - Phone:954-593-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant