Provider Demographics
NPI:1619417029
Name:HERNANDEZ, LILIANA R (MS, BCBA)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:R
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11011 SHERIDAN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1531
Mailing Address - Country:US
Mailing Address - Phone:954-552-6668
Mailing Address - Fax:954-206-5584
Practice Address - Street 1:11011 SHERIDAN ST STE 210
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-1531
Practice Address - Country:US
Practice Address - Phone:954-552-6668
Practice Address - Fax:954-206-5584
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-23-14418106E00000X
FLRBT-18-69094106S00000X
FL1-24-71972103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician