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General NPI Number Information
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NPI Number | 1821873803
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Entity Type | Individual
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Provider Name | SAMUEL HERNANDEZ CARMENATE
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Gender | Male
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 1696 S MILITARY TRL STE C
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-5625
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Country | US
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Telephone | 561-284-6534
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Fax | 561-284-6534
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Provider Business Mailing Address
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Address Line | 1435 SAXONY RD SW
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City | PALM BAY
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State | FL
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Zip | 32908-1106
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Country | US
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Telephone | 561-497-5612
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-86214
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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-23-285552
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License Number State | FL
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