Provider Demographics
NPI:1295040293
Name:HERNANDEZ, YAMILKA
Entity Type:Individual
Prefix:MRS
First Name:YAMILKA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 SW 79 AVE
Mailing Address - Street 2:SUITE 825
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:305-592-0588
Mailing Address - Fax:305-592-0528
Practice Address - Street 1:3900 NW 79TH AVE STE 825
Practice Address - Street 2:3900 NW 79 AVE SUITE #825
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6552
Practice Address - Country:US
Practice Address - Phone:305-592-0588
Practice Address - Fax:305-592-0528
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48695225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist