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NPI Code Detail

MEDICARE: LISIANET HERNANDEZ ESTENOZ

MEDICARE: LISIANET HERNANDEZ ESTENOZ
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 TechnicianBACB1000481FL

General Provider Information

NPI Number : 1407628910
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISIANET HERNANDEZ ESTENOZ
Provider Business Mailing Address
First Line : 3301 E 1ST AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33013-3203
Country : US
Telephone Number : 786-587-2624
Fax Number :
Provider Business Practice Location Address
First Line : 4236 W 16TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-7624
Country : US
Telephone Number : 786-409-2646
Fax Number : 786-953-6553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2023
Last Update Date : 01/07/2026

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Directions to “ LISIANET HERNANDEZ ESTENOZ ” Practice Location

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