MEDICARE: ARIANIA DUPEYRON HERNANDEZ PA

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	9626530	FL
2	246ZC0007X	Surgical Assistant
3	363A00000X	Physician Assistant	TPPA596	FL
4	363AM0700X	Medical Physician Assistant	001726	PR

General Provider Information

NPI Number	:	1366043077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANIA DUPEYRON HERNANDEZ PA

Provider Business Mailing Address
First Line	:	3142 S CONGRESS AVE
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2552
Country	:	US
Telephone Number	:	561-967-3186
Fax Number	:

Provider Business Practice Location Address
First Line	:	3142 S CONGRESS AVE
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2552
Country	:	US
Telephone Number	:	561-967-3186
Fax Number	:

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

Provider Enumeration Date	:	11/08/2020
Last Update Date	:	04/07/2024

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