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General NPI Number Information
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NPI Number | 1508660895
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Entity Type | Individual
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Provider Name | LIANET HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | CALLE BARBOSA ISABELLA #5
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City | ISABELLA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 939-313-0501
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Fax |
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Provider Business Mailing Address
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Address Line | 8480 SW 150TH AVE APT 104
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City | MIAMI
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State | FL
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Zip | 33193-1454
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Country | US
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Telephone | 786-412-3448
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 002522
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License Number State | PR
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