Provider Demographics
NPI:1023635349
Name:HERNANDEZ SANCHEZ, AGNES
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:HERNANDEZ SANCHEZ
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 1:5321 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4905
Mailing Address - Country:US
Mailing Address - Phone:786-720-3988
Mailing Address - Fax:
Practice Address - Street 1:5321 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4905
Practice Address - Country:US
Practice Address - Phone:786-720-3988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician