Provider Demographics
NPI:1033983564
Name:HERNANDEZ, YAZMIN ISABEL
Entity type:Individual
Prefix:
First Name:YAZMIN
Middle Name:ISABEL
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 1:400 FRANDORSON CIR STE 4234
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2648
Mailing Address - Country:US
Mailing Address - Phone:813-324-5523
Mailing Address - Fax:
Practice Address - Street 1:5028 SILVER CHARM TER
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-1582
Practice Address - Country:US
Practice Address - Phone:908-938-1577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty