Provider Demographics
NPI:1538970066
Name:HERNANDEZ, DEYANIRI (APRN)
Entity type:Individual
Prefix:
First Name:DEYANIRI
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11760 SW 40TH ST STE 729
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-8102
Mailing Address - Country:US
Mailing Address - Phone:305-559-8787
Mailing Address - Fax:844-798-8918
Practice Address - Street 1:11760 SW 40TH ST STE 729
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-8102
Practice Address - Country:US
Practice Address - Phone:305-559-8787
Practice Address - Fax:844-798-8918
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036868363LF0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty