Provider Demographics
NPI:1306537980
Name:HERNANDEZ, VIVIANA (RMFT)
Entity type:Individual
Prefix:
First Name:VIVIANA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13335 SW 124TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7513
Mailing Address - Country:US
Mailing Address - Phone:786-738-6468
Mailing Address - Fax:786-551-0212
Practice Address - Street 1:13335 SW 124TH ST STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7513
Practice Address - Country:US
Practice Address - Phone:786-738-6468
Practice Address - Fax:786-551-0212
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT3896101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health