Individual provider Active NPI

Jose A Hernandez, P.A.

  • Physician Assistant
  • Virginia Gardens, FL
National Provider Identifier
1457545915
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9100809 Issued in FL
Practice address
6221 NW 36TH St
Virginia Gardens, FL 33166-7026
Phone
(305) 871-3627
Fax
(305) 871-7569
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9100809 FL Primary

Addresses

Primary practice location

6221 NW 36TH St
Virginia Gardens, FL 33166-7026

Mailing address

4483 NW 36TH St
Suite 120
Miami Springs, FL 33166-7260
Phone (305) 888-7555

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9100809FLMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1457545915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4483 NW 36TH ST",
            "address_2": "SUITE 120",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331667260",
            "telephone_number": "305-888-7555",
            "fax_number": "305-888-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 NW 36TH ST",
            "city": "VIRGINIA GARDENS",
            "state": "FL",
            "postal_code": "331667026",
            "telephone_number": "305-871-3627",
            "fax_number": "305-871-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JOSE",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9100809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.