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Provider Information for 1659893162

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MR. BETSY HERNANDEZ APRN

Gender: FEMALE

Individual NPI: 1659893162

Calendar   Last Updated:  2020-07-08
  Certification Date:  2020-07-08

Details

Name Value
NPI 1659893162
Enumeration Date 2017-07-17
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1324 LAKELAND HILLS BLVD MANAGED CARE DEPT
LAKELAND, FL 33805
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 1324 LAKELAND HILLS BLVD
LAKELAND, FL 33805-4543
United States

Phone: 863-687-1321 | Fax: 863-603-6534
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LF0000X - Nurse Practitioner Family FL ARNP9282301