Basic Information
| Provider Information | |||||||||
| NPI: | 1003007881 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HERNANDEZ | ||||||||
| FirstName: | ALFREDO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.S., LMHC, Q-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7171 SW 62ND AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | SOUTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331434723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052705305 | ||||||||
| FaxNumber: | 3052705306 | ||||||||
| Practice Location | |||||||||
| Address1: | 7171 SW 62ND AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | SOUTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331434723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052705305 | ||||||||
| FaxNumber: | 3052705306 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2007 | ||||||||
| LastUpdateDate: | 11/12/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNamePrefix: | |||||||||
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| NPICertificationDate: | 05/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MH9171 | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.