Provider Demographics
NPI:1295231363
Name:HERNANDEZ OLIVA, CLAUDIA
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:
Last Name:HERNANDEZ OLIVA
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 1:218 ANTIQUERA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2917
Mailing Address - Country:US
Mailing Address - Phone:786-406-0573
Mailing Address - Fax:
Practice Address - Street 1:218 ANTIQUERA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2917
Practice Address - Country:US
Practice Address - Phone:786-406-0573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-166526106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022927600Medicaid