MEDICARE: MS. ARLENE HERNANDEZ P.T.

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	225100000X	Physical Therapist	15880	MD

General Provider Information

NPI Number	:	1508862095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ARLENE HERNANDEZ P.T.

Provider Business Mailing Address
First Line	:	2306 PIONEER CT
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-2670
Country	:	US
Telephone Number	:	301-839-1600
Fax Number	:	301-567-1207

Provider Business Practice Location Address
First Line	:	831 UNIVERSITY BLVD E
Second Line	:	STE 34
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-2915
Country	:	US
Telephone Number	:	301-839-1600
Fax Number	:	301-567-1207

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	12/19/2012

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