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General NPI Number Information
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NPI Number | 1518001593
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Entity Type | Individual
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Provider Name | CLEONE S HERNANDEZ PTA
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Gender | Female
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 01/11/2017
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Provider Practice Location Address
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Address Line | 7993 TANGELO DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-1603
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Country | US
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Telephone | 561-329-2636
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Fax |
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Provider Business Mailing Address
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Address Line | 7993 TANGELO DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-1603
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Country | US
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Telephone | 561-329-2636
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA20155
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License Number State | FL
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