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General NPI Number Information
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NPI Number | 1265998801
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Entity Type | Individual
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Provider Name | LOURDES CHACON HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1317 SW 125TH CT
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City | MIAMI
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State | FL
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Zip | 33184-2338
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Country | US
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Telephone | 305-812-5922
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Fax |
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Provider Business Mailing Address
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Address Line | 19853 SW 7TH PL
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-1258
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Country | US
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Telephone | 305-812-5922
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9551811
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-18-70812
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11024442
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11024442
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License Number State | FL
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