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NPI Code Detail

MEDICARE: DR. EVELYN HERNANDEZ-GONZALEZ PSYD

MEDICARE:  DR. EVELYN  HERNANDEZ-GONZALEZ  PSYD
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
1103T00000XPsychologistPY6661FL

General Provider Information

NPI Number : 1487396354
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVELYN HERNANDEZ-GONZALEZ PSYD
Provider Business Mailing Address
First Line : 901 E KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33602-3502
Country : US
Telephone Number : 813-955-0874
Fax Number :
Provider Business Practice Location Address
First Line : 901 E KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33602-3502
Country : US
Telephone Number : 813-955-0874
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2022
Last Update Date : 04/11/2022

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Directions to “ DR. EVELYN HERNANDEZ-GONZALEZ PSYD” Practice Location

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