Healthcare Provider Details

I. General information

NPI: 1720744394
Provider Name (Legal Business Name): CLAUDIA HERNANDEZ DOMINGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6138 SEVEN SPRINGS BLVD
GREENACRES FL
33463-1603
US

IV. Provider business mailing address

6138 SEVEN SPRINGS BLVD
GREENACRES FL
33463-1603
US

V. Phone/Fax

Practice location:
  • Phone: 561-360-8587
  • Fax:
Mailing address:
  • Phone: 561-360-8587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: