MEDICARE: PRISCILLA HERNANDEZ

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	363LF0000X	Family Nurse Practitioner	9605886	FL

General Provider Information

NPI Number	:	1396687505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA HERNANDEZ

Provider Business Mailing Address
First Line	:	14905 SW 174TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33187-1626
Country	:	US
Telephone Number	:	786-380-7454
Fax Number	:

Provider Business Practice Location Address
First Line	:	14905 SW 174TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33187-1626
Country	:	US
Telephone Number	:	786-380-7454
Fax Number	:

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

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “ PRISCILLA HERNANDEZ ” Practice Location

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