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General NPI Number Information
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NPI Number | 1528342748
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Entity Type | Individual
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Provider Name | IVETT HERNANDEZ PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 6429 GALL BLVD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-2570
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Country | US
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Telephone | 813-782-9571
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Fax |
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Provider Business Mailing Address
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Address Line | 1830 BEARBERRY CIR APT 105
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City | LUTZ
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State | FL
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Zip | 33559-8769
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Country | US
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Telephone | 305-798-5728
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS47795
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License Number State | FL
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