| Doctor Name: | JAMIE LYN HERNANDEZ |
| NPI Number: | 1790191591 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPN |
| License Number: | 60-44-1546773 |
| Business Practice Address: | 4744 Cr 542h Bushnell, FL - 335135558 |
| Business Phone Number: | 7723216276 |
| Business Fax Number: | |
| Mailing Address: | 4744 Cr 542h, BUSHNELL |
| State: | FL |
| Postal Code: | 335135558 |
| Phone Number: | 7723216276 |
| Fax Number: | |
| NPI Enumeration Date: | 07/01/2014 |
| NPI Last Update Date: | 07/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246ZA2600X |
| License Number: | 60-44-1546773 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | Art, Medical |
| Taxonomy Definition: | |