MEDICARE: MARIA XIMENA 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	156FX1800X	Optician	DO8116	FL

General Provider Information

NPI Number	:	1639982788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA XIMENA HERNANDEZ

Provider Business Mailing Address
First Line	:	20872 NE 7TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-1364
Country	:	US
Telephone Number	:	307-725-9872
Fax Number	:

Provider Business Practice Location Address
First Line	:	20872 NE 7TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-1364
Country	:	US
Telephone Number	:	307-725-9872
Fax Number	:

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

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	01/30/2025

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