Lisa Jeanne Bouma Hernandez, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME166907 Issued in FL

Practice address

3464 Avalon Park East Blvd
Orlando, FL 32828-7363

Phone

(407) 635-3020

Fax

(321) 203-4607

NPI assigned

Jan 18, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JIGGCD/Endpoint/JIGGCD
• FHIR API: https://fhir4.healow.com/fhir/r4/ECBEAA/Endpoint/ECBEAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orlando Physicians Network Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1568693554
  Medicare reassignment NPD
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  NPD
• Cruz & Herrera MDS PC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1952599003
  NPD (past)
• Genesis Dentistry PC

  • Dentist
  • Bronx, NY
  • NPI 1548494826
  NPD (past)
• Juan T. Estevez MD PC

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1952596280
  NPD (past)

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1336487784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3464 AVALON PARK EAST BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287363",
            "telephone_number": "407-635-3020",
            "fax_number": "321-203-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3464 AVALON PARK EAST BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287363",
            "telephone_number": "407-635-3020",
            "fax_number": "321-203-4607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3236 N Poinciana Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347464688",
            "country_code": "US",
            "telephone_number": "076-355-9524",
            "fax_number": "407-636-7802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUMA HERNANDEZ",
        "first_name": "LISA",
        "middle_name": "JEANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-18",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "276845",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME166907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124579800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassidy Peyton Boulanger
• Susan Smith Bouldin, LCSW
• Suzy T Boules, M.D
• Sydney Boulier, MS, RD, LDN, CNSC
• Tharwat Stewart Fouad Boulis, MD
• Marsha Ann Bounds, ARNP
• Michelle Lee Bourassa, MA
• Bettina Bourda, OTR/L, CLT
• Virginia Milagros Bouret
• Anissa Lynn Bourgeacq, RDN

• Pediatrics Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.