Healthcare Provider Details

I. General information

NPI: 1740981331
Provider Name (Legal Business Name): INES EILEEN HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 03/13/2023
Certification Date: 03/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1526 RIVER DR APT L303
TAMPA FL
33603-3022
US

IV. Provider business mailing address

1526 RIVER DR APT L303
TAMPA FL
33603-3022
US

V. Phone/Fax

Practice location:
  • Phone: 813-894-4036
  • Fax:
Mailing address:
  • Phone: 813-894-4036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: