Healthcare Provider Details

I. General information

NPI: 1619555661
Provider Name (Legal Business Name): GLADYS L HERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4631 N CONGRESS AVE STE 200
WEST PALM BEACH FL
33407-3234
US

IV. Provider business mailing address

3955 DESIGN CENTER DR APT 702
PALM BEACH GARDENS FL
33410-4382
US

V. Phone/Fax

Practice location:
  • Phone: 561-845-0500
  • Fax: 561-296-1101
Mailing address:
  • Phone: 540-525-8762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME179977
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: