Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1114166998 |
---|---|
Provider Name | Mr. Orlando Hernandez |
First Address | Miami, FL 33184-1703 |
Second Address | Miami, FL 33184-1703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2009 |
Last Update Date | 02/06/2009 |