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Individual

AMALIA HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N/A

Contact information

Practice address
10550 W STATE ROAD 84 LOT 380, DAVIE, FL 33324-4230
(786) 488-0264
Mailing address
10550 W STATE ROAD 84 LOT 380, DAVIE, FL 33324-4230
(786) 488-0264

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
H655-00-76-783-0
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PGQ167M89290
FL
Enumeration date
02/21/2018
Last updated
02/21/2018
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