MEDICARE: HECTOR HERNANDEZ CORDOVA

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	106S00000X	Behavior Technician	RBT-25-451880	FL

General Provider Information

NPI Number	:	1720952617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HECTOR HERNANDEZ CORDOVA

Provider Business Mailing Address
First Line	:	4490 W FLAGLER ST APT 7
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1563
Country	:	US
Telephone Number	:	786-371-4556
Fax Number	:

Provider Business Practice Location Address
First Line	:	4490 W FLAGLER ST APT 7
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1563
Country	:	US
Telephone Number	:	786-371-4556
Fax Number	:

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

Provider Enumeration Date	:	10/02/2025
Last Update Date	:	10/02/2025

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Directions to “ HECTOR HERNANDEZ CORDOVA ” Practice Location

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