Individual ProviderJenine FernandezBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address9220 SW 72nd St Ste 101, Miami, FL 33173(305) 273-7771(786) 273-7771PECOS EnrollmentBased on the most recent information from CMS, provider Jenine Fernandez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 2:35 PM.Profile DetailsProvider ID1104226042Provider TypeIndividualFull NameFernandez, JenineGenderFemaleSole ProprietorYesEnumeration Date8/28/2014Last Updated7/19/2018Contact InformationPractice LocationPractice Address9220 SW 72nd St Ste 101, Miami, FL 33173Phone(305) 273-7771FaxUnlisted FaxMailing LocationMailing Address9220 SW 72nd St Ste 101, Miami, FL 33173-3259Phone(786) 273-7771FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseRBT-18-56115FloridaCode225700000XDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense53159Florida