MEDICARE: MELISSA HERNANDEZ APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	11004637	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174167902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA HERNANDEZ APRN

Provider Business Mailing Address
First Line	:	1553 SAN IGNACIO AVE
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-3090
Country	:	US
Telephone Number	:	305-799-4576
Fax Number	:

Provider Business Practice Location Address
First Line	:	11430 N KENDALL DR # 305B
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1032
Country	:	US
Telephone Number	:	305-799-4576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2019
Last Update Date	:	01/19/2026

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