Healthcare Provider Details

I. General information

NPI: 1457696445
Provider Name (Legal Business Name): VILMA A HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2012
Last Update Date: 12/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 WISCONSIN AVE., NW SUITE 250
WASHINGTON DC
20016
US

IV. Provider business mailing address

5150 WISCONSIN AVE., NW SUITE 250
WASHINGTON DC
20016
US

V. Phone/Fax

Practice location:
  • Phone: 202-526-2400
  • Fax:
Mailing address:
  • Phone: 202-526-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: