MEDICARE: LIADNY R HERNANDEZ

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
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1437935947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIADNY R HERNANDEZ

Provider Business Mailing Address
First Line	:	3435 NW 95TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33147-2749
Country	:	US
Telephone Number	:	786-930-8840
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 NW 95TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33147-2757
Country	:	US
Telephone Number	:	786-930-8840
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2023
Last Update Date	:	08/31/2023

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Directions to “ LIADNY R HERNANDEZ ” Practice Location

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