Provider Demographics
NPI:1932565355
Name:HERNANDEZ, JOAQUIN (APRN-FNP)
Entity Type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 ANCHOR RODE DR
Mailing Address - Street 2:106
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2751
Mailing Address - Country:US
Mailing Address - Phone:786-302-8236
Mailing Address - Fax:
Practice Address - Street 1:801 ANCHOR RODE DR
Practice Address - Street 2:106
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2751
Practice Address - Country:US
Practice Address - Phone:786-302-8236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FL11030183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No104100000XBehavioral Health & Social Service ProvidersSocial Worker