Healthcare Provider Details

I. General information

NPI: 1073381455
Provider Name (Legal Business Name): SONIA HERNANDEZ SUAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 CARDINAL CT
ALTAMONTE SPRINGS FL
32714-1209
US

IV. Provider business mailing address

1255 CARDINAL CT
ALTAMONTE SPRINGS FL
32714-1209
US

V. Phone/Fax

Practice location:
  • Phone: 407-813-4804
  • Fax:
Mailing address:
  • Phone: 407-813-4804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-315222
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-17124
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: