Provider Demographics
NPI:1669357646
Name:HERNANDEZ, SORREL ALEXANDRA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SORREL
Middle Name:ALEXANDRA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 SAN DOMINGO ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5560
Mailing Address - Country:US
Mailing Address - Phone:305-713-5959
Mailing Address - Fax:
Practice Address - Street 1:2521 SAN DOMINGO ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5560
Practice Address - Country:US
Practice Address - Phone:305-713-5959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA22650OtherSTATE SLP LICENSE FROM FDOH
14452430OtherASHA CCC