Provider Demographics
NPI:1386101582
Name:HERNANDEZ, HELENE INDIRA
Entity type:Individual
Prefix:
First Name:HELENE
Middle Name:INDIRA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 GRANDE LAKES BLVD APT 3315
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4055
Mailing Address - Country:US
Mailing Address - Phone:407-692-8821
Mailing Address - Fax:
Practice Address - Street 1:1024 E OSCEOLA PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1607
Practice Address - Country:US
Practice Address - Phone:407-692-8821
Practice Address - Fax:407-641-9803
Is Sole Proprietor?:No
Enumeration Date:2019-02-23
Last Update Date:2019-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI3914235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist