Healthcare Provider Details

I. General information

NPI: 1629903687
Provider Name (Legal Business Name): CELINE HERNANDEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CELINE HERNANDEZ GONZALEZ

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7811 SW STATE ROAD 200
OCALA FL
34476-3975
US

IV. Provider business mailing address

6020 NW 30TH AVE
MIAMI FL
33142-2228
US

V. Phone/Fax

Practice location:
  • Phone: 352-749-3231
  • Fax:
Mailing address:
  • Phone: 786-380-6664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN31887
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: