Provider Demographics
NPI:1235371097
Name:HERNANDEZ, KRISTINA JUDITH (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:JUDITH
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 SW 118TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5654
Mailing Address - Country:US
Mailing Address - Phone:305-206-2553
Mailing Address - Fax:
Practice Address - Street 1:2200 SW 118TH AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5654
Practice Address - Country:US
Practice Address - Phone:305-206-2553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012945101YM0800X
101YM0800X
FLMH6250101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC012945OtherGEORGIA LICENSE#
FLMH6250OtherFLORIDA LICENSE #