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General NPI Number Information
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NPI Number | 1366253833
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Entity Type | Individual
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Provider Name | JESSICA MARIE HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 2500 N MILITARY TRL STE 111
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City | BOCA RATON
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State | FL
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Zip | 33431-6305
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Country | US
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Telephone | 561-826-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 7135 PIGEON KEY WAY
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City | LAKE WORTH
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State | FL
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Zip | 33467-7642
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Country | US
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Telephone | 561-671-9856
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11037211
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | APRN11037211
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License Number State | FL
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