Provider Demographics
NPI:1487396354
Name:HERNANDEZ-GONZALEZ, EVELYN (PSYD)
Entity type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:HERNANDEZ-GONZALEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3502
Mailing Address - Country:US
Mailing Address - Phone:813-955-0874
Mailing Address - Fax:
Practice Address - Street 1:901 E KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-3502
Practice Address - Country:US
Practice Address - Phone:813-955-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6661103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist