=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083654156
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YOLANGEL HERNANDEZ MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2006
-----------------------------------------------------
Last Update Date | 01/04/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | FIU FACULTY GROUP PRACTICE 11200 SW 8TH STREET, UHSC RM 154
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33199-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-348-3627
-----------------------------------------------------
Fax | 305-348-4261
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6101 BLUE LAGOON DR STE 400
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33126-2051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-888-3147
-----------------------------------------------------
Fax | 308-863-3011
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VG0400X
-----------------------------------------------------
Taxonomy Name | Gynecology Physician
-----------------------------------------------------
License Number | ME62740
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------