MEDICARE: CHARLIE A 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	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528615093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLIE A HERNANDEZ

Provider Business Mailing Address
First Line	:	300 INTERNATIONAL PKWY STE 200
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5028
Country	:	US
Telephone Number	:	866-610-0580
Fax Number	:

Provider Business Practice Location Address
First Line	:	4085 HANCOCK BRIDGE PKWY
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-7219
Country	:	US
Telephone Number	:	239-677-3767
Fax Number	:

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

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	07/09/2024

Similar Medicare Providers

1629392261 — CAPE CORAL EYE CENTER, P.A.
Practice Location Address:

4085 HANCOCK BRIDGE PKWY , SUITE 120
N FORT MYERS, FL
33903-7219

Practice Phone: 239-542-2020
Practice Fax: 239-567-5248

1790287662 — MS. DANIELLE LYNN SAWYER
Practice Location Address:

4085 HANCOCK BRIDGE PKWY UNIT 1
NORTH FORT MYERS, FL
33903-7219

Practice Phone: 239-677-3767
Practice Fax:

1932693124 — DANAY ALVAREZ GONZALEZ
Practice Location Address:

4085 HANCOCK BRIDGE PKWY UNIT 10
NORTH FORT MYERS, FL
33903-7219

Practice Phone: 239-677-3767
Practice Fax: 239-236-8081

1285244699 — KARI ANN DINEEN
Practice Location Address:

4085 HANCOCK BRIDGE PKWY
NORTH FORT MYERS, FL
33903-7219

Practice Phone: 239-677-3767
Practice Fax:

1518560358 — YESENIA MEDINA
Practice Location Address:

4085 HANCOCK BRIDGE PKWY
NORTH FORT MYERS, FL
33903-7219

Practice Phone: 239-677-3767
Practice Fax:

1467026690 — OLIVIA LESLEY FAIRMAN
Practice Location Address:

4085 HANCOCK BRIDGE PKWY
NORTH FORT MYERS, FL
33903-7219

Practice Phone: 239-677-3767
Practice Fax:

Directions to “ CHARLIE A HERNANDEZ ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.