Individual
DR. NANCY HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1771
(321) 434-1775
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1771
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME102233
FL
208M00000X
Hospitalist Physician
Primary
ME102233
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000357000
—
FL
01
—
AV090Y
MEDICARE
FL
01
—
ME102233
LICENSE
FL
Enumeration date
05/23/2007
Last updated
05/10/2018
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