Provider Demographics
NPI:1568270387
Name:HERNANDES ALFONSO, FELIX ERNESTO
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:ERNESTO
Last Name:HERNANDES ALFONSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7415
Mailing Address - Country:US
Mailing Address - Phone:954-899-1069
Mailing Address - Fax:
Practice Address - Street 1:310 N 69TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-7416
Practice Address - Country:US
Practice Address - Phone:954-899-1069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician