Healthcare Provider Details

I. General information

NPI: 1285591958
Provider Name (Legal Business Name): IVAN HERNANDEZ ACEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 GOODLETTE-FRANK RD N
NAPLES FL
34102-5614
US

IV. Provider business mailing address

670 GOODLETTE-FRANK RD N
NAPLES FL
34102-5614
US

V. Phone/Fax

Practice location:
  • Phone: 232-316-7656
  • Fax: 232-316-7656
Mailing address:
  • Phone: 232-316-7656
  • Fax: 232-316-7656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: