Healthcare Provider Details

I. General information

NPI: 1750951778
Provider Name (Legal Business Name): YEDY AILED HERNANDEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 W 20TH AVENUE 3RD FLOOR
HIALEAH FL
33016-5183
US

IV. Provider business mailing address

6050 W 20TH AVENUE 3RD FLOOR
HIALEAH FL
33016-5183
US

V. Phone/Fax

Practice location:
  • Phone: 786-584-5555
  • Fax: 786-584-5050
Mailing address:
  • Phone: 786-584-5555
  • Fax: 786-584-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9430169
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06212826
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: