Individual
MARCO HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1200 N CENTRAL AVE STE 110, KISSIMMEE, FL 34741-4439
(407) 201-7429
Mailing address
3191 WINDING TRL, KISSIMMEE, FL 34746-2812
(954) 812-1052
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18542
FL
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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