Provider Demographics
NPI:1689027385
Name:HERNANDEZ, SOLANGEL
Entity Type:Individual
Prefix:
First Name:SOLANGEL
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 1:5344 SW 165TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5270
Mailing Address - Country:US
Mailing Address - Phone:786-327-6209
Mailing Address - Fax:
Practice Address - Street 1:16650 SW 88TH ST STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1283
Practice Address - Country:US
Practice Address - Phone:305-564-1241
Practice Address - Fax:305-901-2048
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ9657235Z00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician