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General NPI Number Information
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NPI Number | 1174030670
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Entity Type | Individual
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Provider Name | JESSICA MARGARITA HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 9036 SW 152ND ST
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1928
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Country | US
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Telephone | 786-340-2687
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Fax | 786-610-1163
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Provider Business Mailing Address
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Address Line | 8130 ROYAL PALM BLVD STE 105
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5703
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Country | US
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Telephone | 954-344-6550
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Fax | 954-344-8634
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 12582361
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License Number State | FL
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