Individual provider Active NPI

Martha M Hernandez

  • Behavior Analyst
  • Naples, FL
National Provider Identifier
1871141069
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2977 Goodlette-Frank Rd N Ste 14
Naples, FL 34103-4613
Phone
(786) 468-1087
NPI assigned
Aug 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

2977 Goodlette-Frank Rd N Ste 14
Naples, FL 34103-4613

Mailing address

15900 SW 197TH Ave
Miami, FL 33187-1108
Phone (786) 468-1087

Other practice location 1

15900 SW 197th Ave
Miami, FL 33187-1108
Phone (786) 468-1087

Other practice location 2

2722 W Tampa Bay Blvd
Tampa, FL 33607-6816
Phone (786) 468-1087

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

Practice roles

OrganizationSpecialtyStatusNew patients
Agency of Behavioral Services Corp Behavior Analyst CurrentSince Mar 31, 2024 Accepting new patients
Imaginary World, LLC Behavior Analyst CurrentSince Dec 1, 2020 Accepting new patients

Locations

2722 W Tampa Bay Blvd
Tampa, FL 33607
Phone (786) 468-1087

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1871141069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15900 SW 197TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331871108",
            "telephone_number": "786-468-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2977 GOODLETTE-FRANK RD N STE 14",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341034613",
            "telephone_number": "786-468-1087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15900 SW 197th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331871108",
            "country_code": "US",
            "telephone_number": "786-468-1087",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2722 W Tampa Bay Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076816",
            "country_code": "US",
            "telephone_number": "786-468-1087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARTHA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.