Healthcare Provider Details

I. General information

NPI: 1720553571
Provider Name (Legal Business Name): CLAUDIA HERNANDEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 PEMBROKE RD
HOLLYWOOD FL
33021-8103
US

IV. Provider business mailing address

2900 CORPORATE WAY # D
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-593-2275
  • Fax: 954-276-0394
Mailing address:
  • Phone: 954-276-5685
  • Fax: 954-985-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9296810
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: