Jackelin Hernandez Sanchez

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

11025588 Issued in FL

Practice address

9800 Touchton Rd Apt 815
Jacksonville, FL 32246-8291

Phone

(732) 930-9574

NPI assigned

Dec 19, 2016

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Advantage Dermatology, PA

  • Dermatology Physician
  • Jacksonville, FL
  • NPI 1255744793
  Medicare reassignment

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1730624289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 COLONIAL DR",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015850",
            "telephone_number": "732-930-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 TOUCHTON RD APT 815",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468291",
            "telephone_number": "732-930-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ SANCHEZ",
        "first_name": "JACKELIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "NJ",
            "license": "16-612",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11025588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Massiel Hernandez Mendez, MD
• Yanet Hernandez Perez, RBT-25-409463
• Sonia I Hernandez Rivera, PH.D.
• Yadilis Hernandez Rodriguez
• Yocelin Hernandez Rojero
• Vivian Rocio Hernandez Torres, MD
• Crystal-Bianca Hernandez-Holubik
• Adilene Hernandez, OTD
• Alexis Arciniaga Hernandez
• Catherine Hernandez

• Primary Care Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.