Provider Demographics
NPI:1215340534
Name:RIVERA HERNANDEZ, MERCEDES (NP)
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:RIVERA HERNANDEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 LONGRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-5755
Mailing Address - Country:US
Mailing Address - Phone:786-355-9334
Mailing Address - Fax:
Practice Address - Street 1:918 LONGRIDGE CT
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-5755
Practice Address - Country:US
Practice Address - Phone:786-355-9334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9335865163W00000X
FL11013941363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse