Provider Demographics
NPI:1982489365
Name:HERNANDEZ, GLADYS
Entity Type:Individual
Prefix:MS
First Name:GLADYS
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 NW 80TH AVE # C-17
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2342
Mailing Address - Country:US
Mailing Address - Phone:954-284-6442
Mailing Address - Fax:
Practice Address - Street 1:9802 NW 80TH AVE # C-17
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2342
Practice Address - Country:US
Practice Address - Phone:954-284-6442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies