=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013752518
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANA HAMADE DMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2024
-----------------------------------------------------
Last Update Date | 06/26/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3120 N MIAMI AVE
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33127-3718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-724-0418
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8366 DYNASTY DR
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33433-6839
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-654-7269
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | DN29246
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------