Provider Demographics
NPI:1508647082
Name:HERNANDEZ ARIAS, MARIA JOSE
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:JOSE
Last Name:HERNANDEZ ARIAS
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 1:16210 CAGAN WOODS
Mailing Address - Street 2:205
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714
Mailing Address - Country:US
Mailing Address - Phone:919-924-4819
Mailing Address - Fax:
Practice Address - Street 1:1200 N CENTRAL AVE STE 110
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4439
Practice Address - Country:US
Practice Address - Phone:407-201-7429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32908225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant