Provider Demographics
NPI:1114248697
Name:HOMER, DANA LESTER (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:LESTER
Last Name:HOMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9474 SW 77TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7482
Mailing Address - Country:US
Mailing Address - Phone:305-282-8890
Mailing Address - Fax:305-270-9729
Practice Address - Street 1:9595 N KENDALL DR STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1979
Practice Address - Country:US
Practice Address - Phone:305-279-8222
Practice Address - Fax:305-270-9030
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004345207V00000X
FLME119928207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology