Provider Demographics
NPI:1578304093
Name:HERNANDEZ CALDERON, MICHELL (APRN)
Entity type:Individual
Prefix:
First Name:MICHELL
Middle Name:
Last Name:HERNANDEZ CALDERON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 NE 29TH ST PH 2006
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5244
Mailing Address - Country:US
Mailing Address - Phone:765-546-1888
Mailing Address - Fax:
Practice Address - Street 1:2300 W 84TH ST STE 101
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5771
Practice Address - Country:US
Practice Address - Phone:786-299-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11032340363LF0000X
IN28223292A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse