MEDICARE: RONNIE 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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1689198665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONNIE HERNANDEZ

Provider Business Mailing Address
First Line	:	9000 BURMA RD STE 109
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1606
Country	:	US
Telephone Number	:	561-508-6122
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 NW 150TH AVE STE 2112
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-2870
Country	:	US
Telephone Number	:	754-264-8779
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2017
Last Update Date	:	07/24/2025

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Directions to “ RONNIE HERNANDEZ ” Practice Location

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