Provider Demographics
NPI:1346900768
Name:HERNANDEZ, MARIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 ATLANTA ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2714
Mailing Address - Country:US
Mailing Address - Phone:786-291-7970
Mailing Address - Fax:
Practice Address - Street 1:4801 S UNIVERSITY DR STE 101
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3835
Practice Address - Country:US
Practice Address - Phone:786-259-0300
Practice Address - Fax:866-665-8671
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT22629OtherSTATE LICENSE