Healthcare Provider Details

I. General information

NPI: 1427994813
Provider Name (Legal Business Name): YASHIRA LINNETTE HERNANDEZ MEDINA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5185 MASSER RD
SAINT CLOUD FL
34772-6427
US

IV. Provider business mailing address

5185 MASSER RD
SAINT CLOUD FL
34772-6427
US

V. Phone/Fax

Practice location:
  • Phone: 407-952-0481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: