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NPI Code Detail

MEDICARE: MARIA HERNANDEZ D.D.S.

MEDICARE: MARIA HERNANDEZ D.D.S.
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
1122300000XDentistDN 12595FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1580745OTHERFLOHS
241121OTHERFLADI

General Provider Information

NPI Number : 1902846967
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA HERNANDEZ D.D.S.
Provider Business Mailing Address
First Line : 2500 SW 107TH AVE
Second Line : SUITE #45
City : MIAMI
State : FL
Zip : 33165-2470
Country : US
Telephone Number : 305-223-5439
Fax Number :
Provider Business Practice Location Address
First Line : 2500 SW 107TH AVE
Second Line : SUITE #45
City : MIAMI
State : FL
Zip : 33165-2470
Country : US
Telephone Number : 305-223-5439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 07/08/2007

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Directions to “ MARIA HERNANDEZ D.D.S.” Practice Location

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