Luisa F Hernandez Medellin, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY9967 Issued in FL

Practice address

2020 Ponce de Leon Blvd Ste 1201
Coral Gables, FL 33134-4476

Phone

(305) 917-5414

Fax

(305) 220-1864

NPI assigned

Oct 13, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Neurobehavioral Health Inc

  • Clinical Neuropsychologist
  • Coral Gables, FL
  • NPI 1285290064
  NPD

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1770094039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 SW 133RD AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331757108",
            "telephone_number": "786-488-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PONCE DE LEON BLVD STE 1201",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344476",
            "telephone_number": "305-917-5414",
            "fax_number": "305-220-1864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9380 SW 72nd St Ste B165",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331735456",
            "country_code": "US",
            "telephone_number": "786-488-9343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ MEDELLIN",
        "first_name": "LUISA",
        "middle_name": "F",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY9967",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9967",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "FL",
            "license": "PY9967",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "FL",
            "license": "PY9967",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY9967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hector Hernandez Cordova
• Lismay Hernandez Dumenigo
• Laura Hernandez Gilimas, RBT
• Juliet Hernandez Guiardinu
• Michel Hernandez Hernandez, APRN
• Hernandez Mental Health, Inc
• Ines Lisette Hernandez Morales, RN
• Yaretmy Hernandez Moreno
• Mariso; Hernandez Nunez
• Claudia Hernandez Oliva

• Clinical Neuropsychologist in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.