Healthcare Provider Details

I. General information

NPI: 1407231822
Provider Name (Legal Business Name): YOSMARY HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14311 SW 88TH ST APT A205
MIAMI FL
33186-8076
US

IV. Provider business mailing address

14311 SW 88TH ST APT A205
MIAMI FL
33186-8076
US

V. Phone/Fax

Practice location:
  • Phone: 786-486-8091
  • Fax:
Mailing address:
  • Phone: 786-486-8091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberCNA-180718
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberCNA-180718
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: