Provider Demographics
NPI:1316651466
Name:HERNANDEZ FUENTES, DERMARY (MSW, RLCSWI)
Entity type:Individual
Prefix:
First Name:DERMARY
Middle Name:
Last Name:HERNANDEZ FUENTES
Suffix:
Gender:F
Credentials:MSW, RLCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4826 SW 49TH RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6299
Mailing Address - Country:US
Mailing Address - Phone:352-679-6711
Mailing Address - Fax:
Practice Address - Street 1:4826 SW 49TH RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474
Practice Address - Country:US
Practice Address - Phone:352-679-6711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR156471041C0700X
FL169131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical