Provider Demographics
NPI:1235968835
Name:HERNANDEZ, MARY CARMEN (PA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CARMEN
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1026 SE FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3821
Mailing Address - Country:US
Mailing Address - Phone:772-210-2447
Mailing Address - Fax:772-261-4028
Practice Address - Street 1:1026 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3821
Practice Address - Country:US
Practice Address - Phone:772-210-2447
Practice Address - Fax:772-261-4028
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-11-11
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant