Healthcare Provider Details

I. General information

NPI: 1902296452
Provider Name (Legal Business Name): LUIS HERNANDEZ-ABREU D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 ALTON RD
MIAMI BEACH FL
33139-3810
US

IV. Provider business mailing address

1400 NW 107TH AVE STE 500
SWEETWATER FL
33172-2746
US

V. Phone/Fax

Practice location:
  • Phone: 305-534-0076
  • Fax:
Mailing address:
  • Phone: 305-910-9817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN13557
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: