Healthcare Provider Details

I. General information

NPI: 1083377964
Provider Name (Legal Business Name): JOEL HERNANDEZ RODRIGUEZ APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 10/21/2024
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 SW 8TH STREET SUITE 200
CORAL GABLES FL
33134-2442
US

IV. Provider business mailing address

5101 SW 8TH STREET SUITE 200
CORAL GABLES FL
33134-2442
US

V. Phone/Fax

Practice location:
  • Phone: 305-262-6060
  • Fax: 305-262-6038
Mailing address:
  • Phone: 305-359-5037
  • Fax: 786-509-5544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11015984
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11015984
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: