Provider Demographics
NPI:1427067875
Name:HERNANDEZ, CIBELES (PHD)
Entity type:Individual
Prefix:
First Name:CIBELES
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 CORAL WAY
Mailing Address - Street 2:402
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3053
Mailing Address - Country:US
Mailing Address - Phone:305-567-0270
Mailing Address - Fax:
Practice Address - Street 1:3400 CORAL WAY
Practice Address - Street 2:402
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3053
Practice Address - Country:US
Practice Address - Phone:305-567-0270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 3408103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5735Medicare PIN
FL75538ZMedicare PIN