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General NPI Number Information
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NPI Number | 1790035921
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Entity Type | Individual
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Provider Name | ELIZABETH HERNANDEZ ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 17121 SW 281ST ST
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City | HOMESTEAD
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State | FL
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Zip | 33030-1905
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Country | US
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Telephone | 305-505-8421
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Fax | 305-675-0340
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Provider Business Mailing Address
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Address Line | 17121 SW 281ST ST
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City | HOMESTEAD
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State | FL
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Zip | 33030-1905
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Country | US
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Telephone | 305-505-8421
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Fax | 305-675-0340
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 9308421
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | C-APN.0001192-C-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9308421
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License Number State | FL
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