Individual provider Active NPI

Stephanie Marie Hernandez, PA-C

  • Medical Physician Assistant
  • Tamarac, FL
National Provider Identifier
1710648464
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9117818 Issued in FL
Practice address
7421 N University Dr Ste 206
Tamarac, FL 33321-2953
Phone
(954) 724-7410
Fax
(954) 724-7412
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA9117818 FL Primary

Addresses

Primary practice location

7421 N University Dr Ste 206
Tamarac, FL 33321-2953

Mailing address

7421 N University Dr Ste 206
Tamarac, FL 33321-2953
Phone (954) 724-7410

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
I20250324002649 FL Practitioner - Physician Assistant 9032631619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osvaldo a Torres MD LLCGroup PAC ID 1557512902, 5 clinicians

Practice addresses (Care Compare)

7421 N University Dr
Sutie 206
Tamarac, FL 33321-2953
Phone (954) 724-7410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9117818FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Medical Center PA Single Specialty PastSince Sep 1, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephanie.hernandez@3689.securemail.prognocis.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1710648464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7421 N UNIVERSITY DR STE 206",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212953",
            "telephone_number": "954-724-7410",
            "fax_number": "954-724-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7421 N UNIVERSITY DR STE 206",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212953",
            "telephone_number": "954-724-7410",
            "fax_number": "954-724-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

Verify at the official NPI Registry.