Provider Demographics
NPI:1790231330
Name:HERNANDEZ, OSMANY
Entity Type:Individual
Prefix:
First Name:OSMANY
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13925 SW 90TH AVE APT A107
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7126
Mailing Address - Country:US
Mailing Address - Phone:786-843-5802
Mailing Address - Fax:
Practice Address - Street 1:13925 SW 90TH AVE APT A107
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7126
Practice Address - Country:US
Practice Address - Phone:786-843-5802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty