Individual provider Active NPI

Juan Carlo Hernandez Jr., M.S., CCC-SLP

  • Speech-Language Pathologist
  • West Palm Beach, FL
National Provider Identifier
1053557454
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA23795 Issued in FL
Practice address
5555 Purdy LN
West Palm Beach, FL 33415-7101
Phone
(561) 432-2300
NPI assigned
Jan 6, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA23795 FL Primary

Addresses

Primary practice location

5555 Purdy LN
West Palm Beach, FL 33415-7101

Mailing address

1608 18TH Ave N
Lake Worth Beach, FL 33460-6406
Phone (561) 876-5694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA23795FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Butterfly Effects Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1053557454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 18TH AVE N",
            "city": "LAKE WORTH BEACH",
            "state": "FL",
            "postal_code": "334606406",
            "telephone_number": "561-876-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PURDY LN",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334157101",
            "telephone_number": "561-432-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JUAN",
        "middle_name": "CARLO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-06",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA23795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.