=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235010604
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAYANA HERNANDEZ RBT-25-471831
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/10/2025
-----------------------------------------------------
Last Update Date | 09/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3970 TAMPA RD STE E
-----------------------------------------------------
City | OLDSMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34677-3201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-305-7037
-----------------------------------------------------
Fax | 813-305-7038
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6603 CROSSBOW LN
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34653-2815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-451-1044
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | RBT-25-471831
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------