Healthcare Provider Details

I. General information

NPI: 1609683275
Provider Name (Legal Business Name): MISLEYDIS HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11001 SW 166TH TER
MIAMI FL
33157-2861
US

IV. Provider business mailing address

11001 SW 166TH TER
MIAMI FL
33157-2861
US

V. Phone/Fax

Practice location:
  • Phone: 786-238-0398
  • Fax:
Mailing address:
  • Phone: 786-238-0398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11036806
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberAPRN11036806
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: