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NPI Code Detail

MEDICARE: DR. ANA FLAVIA HERNANDEZ PEREZ DMD

MEDICARE: DR. ANA FLAVIA HERNANDEZ PEREZ DMD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramFL

General Provider Information

NPI Number : 1780515650
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANA FLAVIA HERNANDEZ PEREZ DMD
Provider Business Mailing Address
First Line : 216 SE CORRECTIONS WAY
Second Line :
City : LAKE CITY
State : FL
Zip : 32025-2013
Country : US
Telephone Number : 386-754-7600
Fax Number :
Provider Business Practice Location Address
First Line : 216 SE CORRECTIONS WAY
Second Line :
City : LAKE CITY
State : FL
Zip : 32025-2013
Country : US
Telephone Number : 386-754-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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