Healthcare Provider Details

I. General information

NPI: 1760302186
Provider Name (Legal Business Name): DAYANA HERNANDEZ CHI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 19TH ST SW
LEHIGH ACRES FL
33976-3630
US

IV. Provider business mailing address

2515 19TH ST SW
LEHIGH ACRES FL
33976-3630
US

V. Phone/Fax

Practice location:
  • Phone: 239-316-9454
  • Fax:
Mailing address:
  • Phone: 239-316-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA1-26-2828979
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: