Provider Demographics
NPI:1922817006
Name:HERNANDEZ, ROSMARY CAROLINA
Entity type:Individual
Prefix:
First Name:ROSMARY
Middle Name:CAROLINA
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 1:2667 GOLD DUST CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-5156
Mailing Address - Country:US
Mailing Address - Phone:786-923-7513
Mailing Address - Fax:
Practice Address - Street 1:2667 GOLD DUST CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5156
Practice Address - Country:US
Practice Address - Phone:786-923-7513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-398445106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician