Provider Demographics
NPI:1700768827
Name:HERNANDEZ ORDUNEZ, ISMAEL
Entity type:Individual
Prefix:MR
First Name:ISMAEL
Middle Name:
Last Name:HERNANDEZ ORDUNEZ
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 1:607 GERALD AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-1013
Mailing Address - Country:US
Mailing Address - Phone:786-660-3580
Mailing Address - Fax:
Practice Address - Street 1:10585 SW 109TH CT STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-3309
Practice Address - Country:US
Practice Address - Phone:305-364-5098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-454645106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician