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General NPI Number Information
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NPI Number | 1043903362
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Entity Type | Individual
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Provider Name | JUAN RAMON HERNANDEZ GONZALEZ DDS
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Gender | Male
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 08/09/2025
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Provider Practice Location Address
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Address Line | 5810 S UNIVERSITY DR STE 128
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City | DAVIE
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State | FL
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Zip | 33328-6109
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Country | US
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Telephone | 800-304-9964
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Fax |
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Provider Business Mailing Address
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Address Line | 212 LAKE POINTE DR APT 311
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City | OAKLAND PARK
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State | FL
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Zip | 33309-3549
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Country | US
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Telephone | 316-395-2069
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN30861
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License Number State | FL
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