Ildefonso Hernandez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

26504 Issued in FL

Practice address

14411 Commerce Way
Miami Lakes, FL 33016-1596

Phone

(305) 625-8844

NPI assigned

Oct 25, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1184136566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 NE 1ST PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330105044",
            "telephone_number": "786-343-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14411 COMMERCE WAY",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161596",
            "telephone_number": "305-625-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "ILDEFONSO",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "26504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arsenio Hernandez
• Claudia Hernandez
• Dailen Hernandez
• Gabriel A. Hernandez, APRN
• Geysell Hernandez
• Irina Hernandez I
• Jimmy Hernandez
• Marelys Hernandez
• Mariana Maria Hernandez
• Mariela Hernandez, SLP

• Physical Therapy Assistant in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; 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.