Healthcare Provider Details

I. General information

NPI: 1750200861
Provider Name (Legal Business Name): IRINA AVILA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 NE 79TH ST APT 910
MIAMI FL
33138-4994
US

IV. Provider business mailing address

234 NE 79TH ST APT 910
MIAMI FL
33138-4994
US

V. Phone/Fax

Practice location:
  • Phone: 786-909-7440
  • Fax:
Mailing address:
  • Phone: 786-909-7440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: