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General NPI Number Information
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NPI Number | 1598177016
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Entity Type | Organization
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Legal Business Name | GEMA JEREZ CORP
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 401 CORAL WAY STE 305
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City | CORAL GABLES
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State | FL
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Zip | 33134-4926
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Country | US
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Telephone | 786-360-6812
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Fax | 786-360-6845
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Provider Business Mailing Address
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Address Line | 401 CORAL WAY STE 305
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City | CORAL GABLES
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State | FL
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Zip | 33134-4926
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Country | US
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Telephone | 786-360-6812
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Fax | 786-360-6845
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEMA HERNANDEZ-JEREZ
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Credential | D.D.S
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Telephone | 786-360-6812
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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 | DN19881
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License Number State | FL
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