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General NPI Number Information
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NPI Number | 1477155067
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Entity Type | Individual
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Provider Name | ANGELICA HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 5959 LAKE ELLENOR DR # 100
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City | ORLANDO
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State | FL
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Zip | 32809-4633
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Country | US
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Telephone | 321-972-4039
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Fax |
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Provider Business Mailing Address
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Address Line | 2325 LAKE DEBRA DR APT 414
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City | ORLANDO
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State | FL
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Zip | 32835-6649
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Country | US
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Telephone | 954-551-8722
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-25-16070
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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 | 20-142770
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License Number State | FL
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