Provider Demographics
NPI:1417836883
Name:HERNANDEZ CORTES, KEVIN JOEL
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:JOEL
Last Name:HERNANDEZ CORTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13900 NARCOOSSEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6960
Mailing Address - Country:US
Mailing Address - Phone:407-240-2107
Mailing Address - Fax:
Practice Address - Street 1:13900 NARCOOSSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6960
Practice Address - Country:US
Practice Address - Phone:407-240-2107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS69480183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist