Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME71391 | FL |
NPI | 1114953916 |
---|---|
Provider Name | Dr. Sharon B Hernandez |
First Address | Sunrise, FL 33323-2865 |
Second Address | Miramar, FL 33029-5592 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 13/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
261516900 | (05) | FL |
51298 | BLUE SHIELD (01) | FL |
G99987 | (02) |