| Doctor Name: | LOURDES HERNANDEZ DE LA ROSA |
| NPI Number: | 1124439138 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SI2391 |
| Business Practice Address: | 904 Lee Blvd Unit 106 Lehigh Acres, FL - 339364953 |
| Business Phone Number: | 2396749374 |
| Business Fax Number: | 2394913057 |
| Mailing Address: | 904 Lee Blvd, Unit 106 LEHIGH ACRES |
| State: | FL |
| Postal Code: | 339364953 |
| Phone Number: | 2396749374 |
| Fax Number: | |
| NPI Enumeration Date: | 05/13/2014 |
| NPI Last Update Date: | 02/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | SI2391 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |