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General NPI Number Information
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NPI Number | 1720696735
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Entity Type | Individual
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Provider Name | ANA CAROLINA HERNANDEZ-ORTIZ DDS
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Gender | Female
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 6720 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-7544
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Country | US
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Telephone | 954-541-9796
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Fax |
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Provider Business Mailing Address
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Address Line | 1593 SW 116TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-5706
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Country | US
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Telephone | 954-628-6552
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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 | 26310
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License Number State | FL
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