Individual ProviderLidey HernandezNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address19755 SW 101st Ave, Cutler Bay, FL 33157-8606(786) 302-8651PECOS EnrollmentBased on the most recent information from CMS, provider Lidey Hernandez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1629673769Provider TypeIndividualFull NameHernandez, LideyCredentialAPRNGenderFemaleSole ProprietorYesEnumeration Date12/4/2020Last Updated12/4/2020Contact InformationPractice LocationPractice Address19755 SW 101st Ave, Cutler Bay, FL 33157-8606Phone(786) 302-8651FaxUnlisted FaxMailing LocationMailing Address19755 SW 101st Ave, Cutler Bay, FL 33157-8606Phone(786) 302-8651FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11010382Florida