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General NPI Number Information
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NPI Number | 1073432803
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Entity Type | Individual
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Provider Name | SAIDEL HERNANDEZ VAZQUEZ
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Gender | Male
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 800 E MERRITT ISLAND CSWY STE 105
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-3514
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Country | US
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Telephone | 321-453-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 1412 GRAVES ST SE
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City | PALM BAY
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State | FL
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Zip | 32909-6436
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Country | US
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Telephone | 585-719-7063
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN32222
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License Number State | FL
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