Provider Demographics
NPI:1205463452
Name:HERNANDEZ, CLAUDIA S
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:S
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 1:307 BRYAN OAK AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7500
Mailing Address - Country:US
Mailing Address - Phone:813-422-4290
Mailing Address - Fax:
Practice Address - Street 1:2013 GOLF MANOR BLVD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-7289
Practice Address - Country:US
Practice Address - Phone:813-422-4290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician