Individual provider Active NPI

Lourdes Hernandez, PSY.D

  • Psychologist
  • Virginia Gardens, FL
National Provider Identifier
1972937324
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY8826 Issued in FL
Practice address
6555 NW 36TH St
Ste 209
Virginia Gardens, FL 33166-6978
Phone
(305) 775-0916
Fax
(305) 602-9834
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X
Psychologist 103T00000X PY8826 FL Primary
Adult Development & Aging Psychologist 103TA0700X
Cognitive & Behavioral Psychologist 103TB0200X
Counseling Psychologist 103TC1900X
Clinical Child & Adolescent Psychologist 103TC2200X
Family Psychologist 103TF0000X
Health Service Psychologist 103TH0100X
Group Psychotherapy Psychologist 103TP2701X
Rehabilitation Psychologist 103TR0400X

Addresses

Primary practice location

6555 NW 36TH St
Ste 209
Virginia Gardens, FL 33166-6978

Mailing address

6555 NW 36TH St
Ste 209
Virginia Gardens, FL 33166-6978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140102001622 FL Practitioner - Clinical Psychologist 7012145782 Practice locations: Miami, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY8826FLMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1972937324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 NW 36TH ST",
            "address_2": "STE 209",
            "city": "VIRGINIA GARDENS",
            "state": "FL",
            "postal_code": "331666978",
            "fax_number": "305-602-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 NW 36TH ST",
            "address_2": "STE 209",
            "city": "VIRGINIA GARDENS",
            "state": "FL",
            "postal_code": "331666978",
            "telephone_number": "305-775-0916",
            "fax_number": "305-602-9834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "LOURDES",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8826",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Gardens, FL

Sources for this page

Verify at the official NPI Registry.