Healthcare Provider Details

I. General information

NPI: 1831005016
Provider Name (Legal Business Name): MARINOLYS HERNANDEZ LUGO RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6219 SPRINGHAVEN DR HOUSTON TX HUMBLE
HUMBLE TX
77396
US

IV. Provider business mailing address

6219 SPRINGHAVEN DR HOUSTON TX HUMBLE
HUMBLE TX
77396
US

V. Phone/Fax

Practice location:
  • Phone: 305-629-0474
  • Fax:
Mailing address:
  • Phone: 305-629-0474
  • 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: