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General NPI Number Information
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NPI Number | 1841855087
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Entity Type | Individual
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Provider Name | MRS. BEATRIZ R HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 12651 W SUNRISE BLVD STE 102
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-888-8355
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Fax | 877-220-7623
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Provider Business Mailing Address
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Address Line | 161 NW 115TH TER
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City | PLANTATION
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State | FL
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Zip | 33325-2515
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Country | US
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Telephone | 964-790-4387
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA85153
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License Number State | FL
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