Provider Demographics
NPI:1538652375
Name:HERNANDEZ MUNOZ, ANA C
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:C
Last Name:HERNANDEZ MUNOZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E ROBINSON ST UNIT 1903
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1998
Mailing Address - Country:US
Mailing Address - Phone:939-788-2274
Mailing Address - Fax:
Practice Address - Street 1:4441 HOFFNER AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-2331
Practice Address - Country:US
Practice Address - Phone:939-788-2274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN240271223G0001X
PR32841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty