Wendy Licet Hernandez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA28806 Issued in FL

Practice address

215 Annie St
Orlando, FL 32806-1207

Phone

(407) 847-4371

NPI assigned

Mar 14, 2019

Last updated

Mar 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Wendy Licet Nieves Former name

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": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1821557315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 ESPLANADE WAY APT 107",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327076816",
            "telephone_number": "321-295-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 ANNIE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061207",
            "telephone_number": "407-847-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "WENDY",
        "middle_name": "LICET",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA28806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "NIEVES",
            "middle_name": "LICET",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steven Michael Hernandez, MD
• Tatiana Eliss Hernandez
• Ulice A Hernandez, M.D ED.
• Valentina Hernandez
• Vinicio Hernandez, M.D.
• Zaleski Kassandra Hernandez, FNP
• James C. Herndon Jr., DC
• Arlene Heron-Polite
• Jill Heroux, LMHC
• Yusdelkys Herrada

• Physical Therapy Assistant in Orlando, FL
• Providers in Orlando, 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 Mar 18, 2019; 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.