Healthcare Provider Details

I. General information

NPI: 1912614967
Provider Name (Legal Business Name): JULIANNE OLANI HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2022
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 OAKS WAY APT 904
POMPANO BEACH FL
33069-5387
US

IV. Provider business mailing address

1637 NW 100TH DR
CORAL SPRINGS FL
33071-5872
US

V. Phone/Fax

Practice location:
  • Phone: 305-807-1909
  • Fax:
Mailing address:
  • Phone: 954-292-2125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: