Individual provider Active NPI

Lissette C. Hernandez, RN

  • Registered Nurse
  • Miami, FL
National Provider Identifier
1447523246
Registry record updated Nov 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN9396800 Issued in FL
Practice address
140 NW 59TH St
Miami, FL 33127-1218
Phone
(305) 759-8888
Fax
(305) 757-5989
NPI assigned
Feb 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN5200908 FL
Registered Nurse 163W00000X RN9396800 FL Primary

Addresses

Primary practice location

140 NW 59TH St
Miami, FL 33127-1218

Mailing address

10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone (305) 252-4820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9396800FLMDRegistered Nurse
PN5200908FLMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Banyan Community Health Center, Inc. PastSince Aug 1, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542412800000",
    "number": "1447523246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-252-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 NW 59TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331271218",
            "telephone_number": "305-759-8888",
            "fax_number": "305-757-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "LISSETTE",
        "middle_name": "C.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2018-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5200908",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9396800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.