=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689982472
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARIDAD HERNANDEZ ARNP, NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2010
-----------------------------------------------------
Last Update Date | 09/15/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6980 W 2ND LN
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-5312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-223-7048
-----------------------------------------------------
Fax | 305-593-1116
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6980 W 2ND LN
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-5312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-223-7048
-----------------------------------------------------
Fax | 305-593-1116
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | ARNP9243861
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------