Healthcare Provider Details

I. General information

NPI: 1437087699
Provider Name (Legal Business Name): MELISSA HERNANDEZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 S DIXIE HWY
CORAL GABLES FL
33146-2926
US

IV. Provider business mailing address

10009 NW 9TH STREET CIR APT 2-15
MIAMI FL
33172-5123
US

V. Phone/Fax

Practice location:
  • Phone: 305-542-4917
  • Fax:
Mailing address:
  • Phone: 305-542-4917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: