Healthcare Provider Details

I. General information

NPI: 1922866482
Provider Name (Legal Business Name): YAISY HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 NW 186TH ST APT 204
HIALEAH FL
33015-3109
US

IV. Provider business mailing address

7010 NW 186TH ST APT 204
HIALEAH FL
33015-3109
US

V. Phone/Fax

Practice location:
  • Phone: 786-826-3832
  • Fax:
Mailing address:
  • Phone: 786-826-3832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA-1-26-89878
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: