1467648071 NPI number — BEATRIZ BAELLA HERNANDEZ LCSW,PLLC

Table of content: (NPI 1467648071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467648071 NPI number — BEATRIZ BAELLA HERNANDEZ LCSW,PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEATRIZ BAELLA HERNANDEZ LCSW,PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467648071
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7101 SLEEPY HOLW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TALLAHASSEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32312-7563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-443-1974
Provider Business Mailing Address Fax Number:
850-422-1923

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2888 MAHAN DR
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
TALLAHASSEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32308-5464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-443-1974
Provider Business Practice Location Address Fax Number:
850-422-1923
Provider Enumeration Date:
09/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BAELLA HERNANDEZ
Authorized Official First Name:
BEATRIZ
Authorized Official Middle Name:
G.
Authorized Official Title or Position:
MEMBER MANAGER
Authorized Official Telephone Number:
850-443-1974

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW 8676 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com