=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508731969
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WINGS OF HARMONY SUPPORT CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2025
-----------------------------------------------------
Last Update Date | 10/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6447 MIAMI LAKES DR E STE 210D
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-2760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-775-2078
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6447 MIAMI LAKES DR E STE 210D
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-2760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-775-2078
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | VICTOR J HERNANDEZ FERNANDEZ
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 786-775-2078
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------