Healthcare Provider Details

I. General information

NPI: 1497663280
Provider Name (Legal Business Name): ROSA MARIA HERNANDEZ ADAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14791 OAK LN
MIAMI LAKES FL
33016-1518
US

IV. Provider business mailing address

14791 OAK LN
MIAMI LAKES FL
33016-1518
US

V. Phone/Fax

Practice location:
  • Phone: 305-330-9977
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License NumberRPT43948
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: