MEDICARE: ALICIA HERNANDEZ MIGUEZ

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-24-397064	FL

General Provider Information

NPI Number	:	1760361307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA HERNANDEZ MIGUEZ

Provider Business Mailing Address
First Line	:	2771 N 66TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2908
Country	:	US
Telephone Number	:	954-696-0070
Fax Number	:

Provider Business Practice Location Address
First Line	:	2771 N 66TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2908
Country	:	US
Telephone Number	:	954-696-0070
Fax Number	:

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

Provider Enumeration Date	:	08/28/2025
Last Update Date	:	08/28/2025

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Directions to “ ALICIA HERNANDEZ MIGUEZ ” Practice Location

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