MEDICARE: KARELYS HERNANDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	CBHCM0107119-P	FL

General Provider Information

NPI Number	:	1285441725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARELYS HERNANDEZ

Provider Business Mailing Address
First Line	:	3910 NW 165TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33054-6223
Country	:	US
Telephone Number	:	786-567-1322
Fax Number	:

Provider Business Practice Location Address
First Line	:	3910 NW 165TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33054-6223
Country	:	US
Telephone Number	:	786-567-1322
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2024
Last Update Date	:	12/17/2024

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Directions to “ KARELYS HERNANDEZ ” Practice Location

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