Most Relevant Information
Provider Data
| NPI Number: | 1003508920 |
| Provider Name: | MIRIAIMYS CARMEN HERNANDEZ GOMEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/22/2023 |
| Last Updated: | 05/22/2023 |
Provider Practice Location
2213 NE 2ND PL
CAPE CORAL
FL
339094270
Practice Location Phone/Fax
| Phone: | 2392450767 |
| Fax: |
Provider Mailing Location
2213 NE 2ND PL
CAPE CORAL
FL
339094270
Provider Mailing Phone/Fax
| Phone: | 2392450767 |
| Fax: |