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General NPI Number Information
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NPI Number | 1053204792
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Entity Type | Individual
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Provider Name | OKAERI ALDAIR HERNANDEZ OD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1107 BELTLINE RD SE STE C
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City | DECATUR
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State | AL
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Zip | 35601-6556
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Country | US
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Telephone | 256-822-7593
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Fax |
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Provider Business Mailing Address
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Address Line | 39 FRIENDSHIP RD
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City | SOMERVILLE
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State | AL
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Zip | 35670-3707
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Country | US
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Telephone | 256-565-4211
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S-F64
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License Number State | AL
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