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NPI Code Detail

MEDICARE: ALEXIS HERNANDEZ

MEDICARE: ALEXIS HERNANDEZ
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-22-2241479IL

General Provider Information

NPI Number : 1548960115
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS HERNANDEZ
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 251 W 84TH DR
Second Line :
City : MERRILLVILLE
State : IN
Zip : 46410-6243
Country : US
Telephone Number : 219-205-3463
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2023
Last Update Date : 04/15/2026

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Directions to “ ALEXIS HERNANDEZ ” Practice Location

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