Provider Demographics
NPI:1881452704
Name:HERNANDEZ, INGRID ISABEL (APRN)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:ISABEL
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3127 NW 84TH WAY
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8907
Mailing Address - Country:US
Mailing Address - Phone:754-207-0790
Mailing Address - Fax:
Practice Address - Street 1:2820 NE 214TH ST STE 824
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1270
Practice Address - Country:US
Practice Address - Phone:754-207-0790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily