MEDICARE: INGRID ISABEL 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	363LF0000X	Family Nurse Practitioner	11031577	FL

General Provider Information

NPI Number	:	1881452704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INGRID ISABEL HERNANDEZ APRN

Provider Business Mailing Address
First Line	:	3127 NW 84TH WAY
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33351-8907
Country	:	US
Telephone Number	:	754-207-0790
Fax Number	:

Provider Business Practice Location Address
First Line	:	9900 STIRLING RD STE 301
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8066
Country	:	US
Telephone Number	:	754-207-0790
Fax Number	:

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

Provider Enumeration Date	:	03/06/2024
Last Update Date	:	05/05/2026

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