Provider Demographics
NPI:1336379445
Name:HERNANDEZ, NORDA (PSYD)
Entity type:Individual
Prefix:DR
First Name:NORDA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 BAMBOO LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2419
Mailing Address - Country:US
Mailing Address - Phone:954-536-4311
Mailing Address - Fax:954-385-3303
Practice Address - Street 1:1730 MAIN ST
Practice Address - Street 2:SUITE 218
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3675
Practice Address - Country:US
Practice Address - Phone:954-536-4311
Practice Address - Fax:954-385-3303
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-04-1252103K00000X
FLPY7910103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst