MEDICARE: BLANCA ESTELA 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	163W00000X	Registered Nurse	RN9349747	FL
2	363L00000X	Nurse Practitioner	APRN11020221	FL
3	363LF0000X	Family Nurse Practitioner	APRN11020221	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	:	1306462254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLANCA ESTELA HERNANDEZ APRN

Provider Business Mailing Address
First Line	:	3227 S HORSESHOE DR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-6114
Country	:	US
Telephone Number	:	239-449-9882
Fax Number	:	239-449-9884

Provider Business Practice Location Address
First Line	:	3227 S HORSESHOE DR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-6114
Country	:	US
Telephone Number	:	239-449-9882
Fax Number	:	239-449-9884

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

Provider Enumeration Date	:	06/16/2020
Last Update Date	:	12/03/2024

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