Active NPI
Samantha Delilena Hernandez
- Behavior Technician
- Davie, FL
National Provider Identifier
1770262453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB872356
- Practice address
- 5400 S University Dr
Davie, FL 33328-5312 - Phone
- (954) 513-9545
- NPI assigned
- Jul 11, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB872356 | FL | Primary |
Addresses
Primary practice location
5400 S University Dr
Davie, FL 33328-5312
Mailing address
12527 NW 58TH MNR
Coral Springs, FL 33076-1933
Phone (561) 545-0339
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
| License | State | Type | Specialty |
|---|---|---|---|
| BACB872356 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1770262453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12527 NW 58TH MNR",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330761933",
"telephone_number": "561-545-0339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 S UNIVERSITY DR",
"city": "DAVIE",
"state": "FL",
"postal_code": "333285312",
"telephone_number": "954-513-9545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "SAMANTHA",
"middle_name": "DELILENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-11",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "BACB872356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.