MEDICARE: GEIDY 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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1952677908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEIDY HERNANDEZ

Provider Business Mailing Address
First Line	:	5126 NET DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5095
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5126 NET DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5095
Country	:	US
Telephone Number	:	512-322-3927
Fax Number	:

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

Provider Enumeration Date	:	03/23/2012
Last Update Date	:	03/23/2012

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Directions to “ GEIDY HERNANDEZ ” Practice Location

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