Healthcare Provider Details
I. General information
NPI: 1033460266
Provider Name (Legal Business Name): RONCHELLA HANKERSON B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/27/2012
Last Update Date: 09/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
155 SOUTH MIAMI AVENUE SUITE 700
MIAMI FL
33130
US
IV. Provider business mailing address
26161 SW 132 PLACE
HOMESTEAD FL
33032
US
V. Phone/Fax
- Phone: 305-779-9600
- Fax: 305-779-9600
- Phone: 786-222-2354
- Fax: 786-779-9601
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: