Provider Demographics
NPI:1932703535
Name:HERNANDEZ, MARIA ANTONIETA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANTONIETA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6419 SW 133RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5068
Mailing Address - Country:US
Mailing Address - Phone:305-776-3872
Mailing Address - Fax:
Practice Address - Street 1:14491 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-7818
Practice Address - Country:US
Practice Address - Phone:305-229-1044
Practice Address - Fax:305-229-9039
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist