Healthcare Provider Details

I. General information

NPI: 1639506926
Provider Name (Legal Business Name): LOURDES HERNANDEZ PSYD ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 11/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8360 W FLAGLER ST STE 202
MIAMI FL
33144-2042
US

IV. Provider business mailing address

8360 W FLAGLER ST STE 202
MIAMI FL
33144-2042
US

V. Phone/Fax

Practice location:
  • Phone: 305-775-0916
  • Fax:
Mailing address:
  • Phone: 305-775-0916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPY8826
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY8826
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPY8826
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPY8826
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY8826
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY8826
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY8826
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPY8826
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPY8826
License Number StateFL
# 10
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberPY8826
License Number StateFL
# 11
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPY8826
License Number StateFL
# 12
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License NumberPY8826
License Number StateFL
# 13
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPY8826
License Number StateFL
# 14
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberPY8826
License Number StateFL
# 15
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY8826
License Number StateFL

VIII. Authorized Official

Name: LOURDES HERNANDEZ
Title or Position: DIRECTOR
Credential: PSY.D.
Phone: 305-775-0916