Provider Demographics
NPI:1356018469
Name:ANGARICA HERNANDEZ, MAGALY
Entity Type:Individual
Prefix:
First Name:MAGALY
Middle Name:
Last Name:ANGARICA 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 1:7259 W 24TH AVE APT 112
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6548
Mailing Address - Country:US
Mailing Address - Phone:908-986-8506
Mailing Address - Fax:
Practice Address - Street 1:7259 W 24TH AVE APT 112
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-6548
Practice Address - Country:US
Practice Address - Phone:908-986-8506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-152881106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician