Provider Demographics
NPI:1740009828
Name:HERNANDEZ GARCIA, JOSE MIGUEL (RBT)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:MIGUEL
Last Name:HERNANDEZ GARCIA
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 CENTERGATE DR APT 108
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7294
Mailing Address - Country:US
Mailing Address - Phone:786-285-7732
Mailing Address - Fax:
Practice Address - Street 1:2451 CENTERGATE DR APT 108
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7294
Practice Address - Country:US
Practice Address - Phone:786-285-7732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-383170106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty