Individual
MRS. LESLIE E. HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
213 HIALEAH AVE, FORT PIERCE, FL 34982-3420
(772) 409-7348
Mailing address
213 HIALEAH AVE, FORT PIERCE, FL 34982-3420
(772) 409-7348
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686009579
—
FL
Enumeration date
07/05/2012
Last updated
07/05/2012
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