=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437087699
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELISSA HERNANDEZ
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2026
-----------------------------------------------------
Last Update Date | 05/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1320 S DIXIE HWY
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33146-2926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-542-4917
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10009 NW 9TH STREET CIR APT 2-15
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33172-5123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-542-4917
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------