Individual provider Active NPI

Marina Hernandez Hernandez

  • Assistant Behavior Analyst
  • Saint Cloud, FL
National Provider Identifier
1164062691
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-22-13891 Issued in FL
Practice address
4207 Sky Flower LN
Saint Cloud, FL 34772-8842
Phone
(786) 282-2588
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-22-13891 FL Primary

Addresses

Primary practice location

4207 Sky Flower LN
Saint Cloud, FL 34772-8842

Mailing address

4207 Sky Flower LN
Saint Cloud, FL 34772-8842
Phone (786) 282-2588

Other identifiers 1

IdentifierTypeStateIssuer
103375900MedicaidFL

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

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1164062691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 SKY FLOWER LN",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347728842",
            "telephone_number": "786-282-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 SKY FLOWER LN",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347728842",
            "telephone_number": "786-282-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ HERNANDEZ",
        "first_name": "MARINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-22-13891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103375900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.