Individual provider Active NPI

Marie Hernandez, APRN

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1396318853
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11014209 Issued in FL
Practice address
258 S Chickasaw TRL Ste 203
Orlando, FL 32825-3558
Phone
(407) 303-6588
NPI assigned
Jul 22, 2021
Last updated
Oct 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11014209 FL Primary
Pediatric Nurse Practitioner 363LP0200X 11014209 FL

Addresses

Primary practice location

258 S Chickasaw TRL Ste 203
Orlando, FL 32825-3558

Mailing address

258 S Chickasaw TRL Ste 203
Orlando, FL 32825-3558
Phone (407) 303-6588

Other practice location 1

5005 Port St John Pkwy
Port St John, FL 32927-4305
Phone (321) 633-8620

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pediatrics@healthychildrenfl.com

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230208001030 FL Practitioner - Nurse Practitioner 3678945284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Hahnemann University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

258 S Chickasaw TRL
Orlando, FL 32825-3501

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11014209FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Oct 23, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 23, 2023 Accepting new patients
Isidro a Lopez MD PA PastSince Jul 1, 2021 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

258 S Chickasaw Trl
Ste 203
Orlando, FL 32825
Phone (407) 303-6588

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mhernandez2012351@adventhealth.direct-ci.com

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1396318853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253558",
            "telephone_number": "407-303-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253558",
            "telephone_number": "407-303-6588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 Port St John Pkwy",
            "address_purpose": "LOCATION",
            "city": "Port St John",
            "state": "FL",
            "postal_code": "329274305",
            "country_code": "US",
            "telephone_number": "321-633-8620",
            "fax_number": "321-633-8622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11014209",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11014209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pediatrics@healthychildrenfl.com",
            "affiliation": "N",
            "address_1": "1495 NW 20th St",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331427723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.