Provider Demographics
NPI:1851143762
Name:HERNANDEZ, NATALIE MONICA
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MONICA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MONICA
Other - Last Name:MANDRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:853 NE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-5922
Mailing Address - Country:US
Mailing Address - Phone:305-432-8311
Mailing Address - Fax:
Practice Address - Street 1:853 NE 10TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-5922
Practice Address - Country:US
Practice Address - Phone:305-432-8311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY12228103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical