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NPI Code Detail

MEDICARE: DIANELA HERNANDEZ JUNCO

MEDICARE:   DIANELA  HERNANDEZ JUNCO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-23-316460FL

General Provider Information

NPI Number : 1235979857
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANELA HERNANDEZ JUNCO
Provider Business Mailing Address
First Line : 8040 NW 95TH ST STE 217
Second Line :
City : HIALEAH GARDENS
State : FL
Zip : 33016-2361
Country : US
Telephone Number : 954-397-8635
Fax Number :
Provider Business Practice Location Address
First Line : 922 E 28TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33013-3419
Country : US
Telephone Number : 786-556-2214
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2024
Last Update Date : 05/31/2024

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Directions to “ DIANELA HERNANDEZ JUNCO ” Practice Location

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