Individual provider Active NPI

Ermis Hernandez

  • Behavior Technician
  • Hollywood, FL
National Provider Identifier
1104498526
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-296688 Issued in FL
Practice address
9900 Stirling Rd Ste 103
Hollywood, FL 33024-8073
Phone
(954) 300-2921
Fax
(954) 901-2815
NPI assigned
Jul 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Behavior Technician 106S00000X RBT-23-296688 FL Primary

Addresses

Primary practice location

9900 Stirling Rd Ste 103
Hollywood, FL 33024-8073

Mailing address

9050 Pines Blvd Ste 205
Pembroke Pines, FL 33024-6415
Phone (547) 444-1829

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

State licenses

LicenseStateTypeSpecialty
RBT-23-296688FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Broward Behavioral and Community Services, Inc CurrentSince Nov 12, 2023 Accepting new patients

Locations

9050 Pines Blvd
Ste 205
Pembroke Pines, FL 33024
Phone (954) 744-4182

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": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1104498526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 PINES BLVD STE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246415",
            "telephone_number": "547-444-1829",
            "fax_number": "954-842-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 STIRLING RD STE 103",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248073",
            "telephone_number": "954-300-2921",
            "fax_number": "954-901-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ERMIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-296688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.