Provider Demographics
NPI:1609692805
Name:HERNANDEZ, JENIFER (RCSWI)
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5159 LAZY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9277
Mailing Address - Country:US
Mailing Address - Phone:407-810-5170
Mailing Address - Fax:
Practice Address - Street 1:2345 SAND LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-9142
Practice Address - Country:US
Practice Address - Phone:407-851-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical