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NPI Code Detail

MEDICARE: LUIS ANDRES HERNANDEZ ARISTA

MEDICARE: LUIS ANDRES HERNANDEZ ARISTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-23-305301
2103K00000XBehavior Analyst1-26-87695FL

General Provider Information

NPI Number : 1104696269
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS ANDRES HERNANDEZ ARISTA
Provider Business Mailing Address
First Line : 13424 FORT KING RD
Second Line :
City : DADE CITY
State : FL
Zip : 33525-5214
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13424 FORT KING RD FL USA
Second Line :
City : DADE CITY
State : FL
Zip : 33525-5214
Country : US
Telephone Number : 352-437-3559
Fax Number : 352-608-9017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2024
Last Update Date : 02/17/2026

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Directions to “ LUIS ANDRES HERNANDEZ ARISTA ” Practice Location

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