| Organization Name: | TATIANA L HERNANDEZ MD PA |
| NPI Number: | 1164601191 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSE DAVID HERNANDEZ (OFFICE MANAGER) |
| Mailing Address: | 3633 Little Rd Suite # 103 Trinity |
| State: | FL US |
| Postal Code: | 346551815 |
| Phone Number: | 7278531800 |
| Fax Number: | 7278531807 |
| NPI Enumeration Date: | 10/26/2007 |
| NPI Last Update Date: | 01/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | ME90671 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |