Healthcare Provider Details

I. General information

NPI: 1457282592
Provider Name (Legal Business Name): NICHOLETTE HERNANDEZ LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 NORTHPOINT PKWY STE 60
WEST PALM BEACH FL
33407-1994
US

IV. Provider business mailing address

801 NORTHPOINT PKWY STE 60
WEST PALM BEACH FL
33407-1994
US

V. Phone/Fax

Practice location:
  • Phone: 561-888-7289
  • Fax:
Mailing address:
  • Phone: 561-888-7289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA84373
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: