Healthcare Provider Details

I. General information

NPI: 1821921974
Provider Name (Legal Business Name): AYLEN HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7556 LAKE WORTH RD
GREENACRES FL
33467-2503
US

IV. Provider business mailing address

240 DAVIS RD
PALM SPRINGS FL
33461-1903
US

V. Phone/Fax

Practice location:
  • Phone: 561-894-1370
  • Fax:
Mailing address:
  • Phone: 561-891-7847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11047390
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: