Healthcare Provider Details

I. General information

NPI: 1285190793
Provider Name (Legal Business Name): AINEK VIDAL HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 SW 122ND AVE APT 415
MIAMI FL
33175-7357
US

IV. Provider business mailing address

2055 SW 122ND AVE APT 415
MIAMI FL
33175-7357
US

V. Phone/Fax

Practice location:
  • Phone: 786-626-2522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-2840838
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: