Provider Demographics
NPI:1295849719
Name:HERNANDEZ, RAMON E (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:E
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 N ATLANTIC AVE
Mailing Address - Street 2:905
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-5213
Mailing Address - Country:US
Mailing Address - Phone:321-784-2236
Mailing Address - Fax:321-799-9721
Practice Address - Street 1:1980 N ATLANTIC AVE
Practice Address - Street 2:905
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-5213
Practice Address - Country:US
Practice Address - Phone:321-784-2236
Practice Address - Fax:321-799-9721
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00144521223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics