Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | MA61486 | FL |
Y | 225X00000X | Occupational Therapist | OT16659 | FL |
N | 225XE0001X | Environmental Modification | OT16659 | FL |
N | 225XF0002X | Feeding, Eating & Swallowing | OT16659 | FL |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT16659 | FL |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT16659 | FL |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT16659 | FL |
NPI | 1144763681 |
---|---|
Provider Name | Krystina Hernandez |
First Address | Pembroke Pines, FL 33029-6052 |
Second Address | Pembroke Pines, FL 33029-6052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2016 |
Last Update Date | 17/02/2017 |