MEDICARE: DR. CHRISTINA S. HERNANDEZ, DMD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457986424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. CHRISTINA S. HERNANDEZ, DMD, PA

Provider Business Mailing Address
First Line	:	12280 MIRAMAR BLVD
Second Line	:	SUITE #2
City	:	MIRAMAR
State	:	FL
Zip	:	33025
Country	:	US
Telephone Number	:	787-402-1478
Fax Number	:

Provider Business Practice Location Address
First Line	:	12280 MIRAMAR BLVD
Second Line	:	SUITE #2
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3302
Country	:	US
Telephone Number	:	787-402-1478
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRISTINA SOFIA HERNANDEZ
Credential	:	DMD
Telephone Number	:	787-402-1478

Provider Enumeration Date	:	03/10/2020
Last Update Date	:	03/10/2020

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