Healthcare Provider Details

I. General information

NPI: 1962005157
Provider Name (Legal Business Name): YUNIA HERNANDEZ LOPEZ APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11211 N NEBRASKA AVE
TAMPA FL
33612-5777
US

IV. Provider business mailing address

2417 TOWERY TRL
LUTZ FL
33549-3779
US

V. Phone/Fax

Practice location:
  • Phone: 813-514-2333
  • Fax:
Mailing address:
  • Phone: 786-486-4355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11024300
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9547860
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: