Organization Active NPI

Tatiana L Hernandez MD PA

  • Primary Care Clinic/Center
  • Trinity, FL
National Provider Identifier
1164601191
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME90671 Issued in FL
Legal business name
TATIANA L HERNANDEZ MD PA
Practice address
3633 Little Rd
Suite # 103
Trinity, FL 34655-1815
Phone
(727) 853-1800
Fax
(727) 853-1807
NPI assigned
Oct 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jose David Hernandez
Title
Office Manager
Phone
(727) 853-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME90671 FL Primary

Addresses

Primary practice location

3633 Little Rd
Suite # 103
Trinity, FL 34655-1815

Mailing address

3633 Little Rd
Suite # 103
Trinity, FL 34655-1815
Phone (727) 853-1800

Other names 1

  • Trinity Family HealthCare Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080109000271 FL Part B Supplier - Clinic/Group Practice 7113007626 Receives reassigned benefits from 3 practitioners
Practice locations: New Port Richey, FL; Trinity, FL

National Provider Directory

National Provider Directory

Locations

2155 Little Rd
Trinity, FL 34655
Phone (727) 853-1800

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1164601191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 LITTLE RD",
            "address_2": "SUITE # 103",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551815",
            "telephone_number": "727-853-1800",
            "fax_number": "727-853-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 LITTLE RD",
            "address_2": "SUITE # 103",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551815",
            "telephone_number": "727-853-1800",
            "fax_number": "727-853-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TATIANA L HERNANDEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "727-853-1800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME90671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Family HealthCare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.