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General NPI Number Information
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NPI Number | 1568079135
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Entity Type | Individual
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Provider Name | VERONICA VIRGINIA ALFONZO HERNANDEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 10640 GRIFFIN RD STE 101
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City | DAVIE
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State | FL
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Zip | 33328-3214
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Country | US
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Telephone | 954-252-1390
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Fax |
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Provider Business Mailing Address
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Address Line | 1559 SW 119TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-5784
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Country | US
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Telephone | 786-603-8659
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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 | 27292
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License Number State | FL
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