Provider Demographics
NPI:1548865686
Name:HERNANDEZ, YURIEN
Entity type:Individual
Prefix:MR
First Name:YURIEN
Middle Name:
Last Name:HERNANDEZ
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 1:4241 SW 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4138
Mailing Address - Country:US
Mailing Address - Phone:305-300-6144
Mailing Address - Fax:888-822-6668
Practice Address - Street 1:1818 W FLAGLER ST STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1915
Practice Address - Country:US
Practice Address - Phone:305-300-6144
Practice Address - Fax:305-300-6144
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL126510100Medicaid