Provider Demographics
NPI:1679646673
Name:HERNANDEZ, MARIA ANDREINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ANDREINA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 PINEWALK DR N
Mailing Address - Street 2:APT 201
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7811
Mailing Address - Country:US
Mailing Address - Phone:954-752-1798
Mailing Address - Fax:
Practice Address - Street 1:3200 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:965-262-7357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDTP4681223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics