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General NPI Number Information
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NPI Number | 1679150114
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Entity Type | Individual
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Provider Name | KRISTEN MARIE HERNANDEZ DO
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Gender | Female
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 6200 SW 73RD ST
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4679
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Country | US
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Telephone | 786-662-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 6436 S MITCHELL MANOR CIR
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City | PINECREST
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State | FL
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Zip | 33156-4879
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 328973
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS22622
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License Number State | FL
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