MEDICARE: MR. YANIO HERNANDEZ PMHNP-BC

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	363LF0000X	Family Nurse Practitioner	APRN9247177	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN9247177	FL

General Provider Information

NPI Number	:	1316436389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. YANIO HERNANDEZ PMHNP-BC

Provider Business Mailing Address
First Line	:	3945 NW 57TH PL
Second Line	:
City	:	VIRGINIA GARDENS
State	:	FL
Zip	:	33166-5710
Country	:	US
Telephone Number	:	305-607-0971
Fax Number	:

Provider Business Practice Location Address
First Line	:	12260 SW 8TH ST STE 154
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-1508
Country	:	US
Telephone Number	:	786-409-5503
Fax Number	:

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

Provider Enumeration Date	:	05/06/2018
Last Update Date	:	10/28/2024

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