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General NPI Number Information
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NPI Number | 1740142264
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Entity Type | Individual
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Provider Name | TAMARA HERNANDEZ RODRIGUEZ APRN
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 580 NW UNIVERSITY BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-2221
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Country | US
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Telephone | 954-697-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 580 NW UNIVERSITY BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-2221
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Country | US
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Telephone | 954-697-9292
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11044002
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License Number State | FL
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