Provider Demographics
NPI:1407669682
Name:HERNANDEZ GUERRA, ANA BELEN
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:BELEN
Last Name:HERNANDEZ GUERRA
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 1:20119 NW 36TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-1775
Mailing Address - Country:US
Mailing Address - Phone:786-653-0838
Mailing Address - Fax:
Practice Address - Street 1:20119 NW 36TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-1775
Practice Address - Country:US
Practice Address - Phone:786-653-0838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-346193106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician