Provider Demographics
NPI:1275693822
Name:NORBERTO J HERNANDEZ D.D.S. P.A.
Entity Type:Organization
Organization Name:NORBERTO J HERNANDEZ D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NORBERTO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-642-7796
Mailing Address - Street 1:1235 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4723
Mailing Address - Country:US
Mailing Address - Phone:305-642-7796
Mailing Address - Fax:
Practice Address - Street 1:1235 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4723
Practice Address - Country:US
Practice Address - Phone:305-642-7796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN-00144511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty