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General NPI Number Information
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NPI Number | 1467146332
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Entity Type | Individual
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Provider Name | MARY ISANDRA HERRERO HERRERA
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Gender | Female
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 1231 BLACKWOOD AVE
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City | OCOEE
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State | FL
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Zip | 34761-4521
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Country | US
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Telephone | 480-743-7010
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Fax |
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Provider Business Mailing Address
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Address Line | 7510 GENTIAN ST
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City | ORLANDO
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State | FL
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Zip | 32822-5507
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Country | US
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Telephone | 480-743-7010
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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 | DN30845
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License Number State | FL
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