Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH9171 | FL |
NPI | 1003007881 |
---|---|
Provider Name | Mr. Alfredo Hernandez |
First Address | South Miami, FL 33143-4723 |
Second Address | South Miami, FL 33143-4723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 12/11/2021 |