Individual
MARTHA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1902 20TH AVE W, BRADENTON, FL 34205-5716
(941) 748-2757
Mailing address
1902 20TH AVE W, BRADENTON, FL 34205-5716
(941) 748-2757
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11902
FL
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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