Provider Demographics
NPI:1861456030
Name:JUNCO, HECTOR ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:ALEJANDRO
Last Name:JUNCO
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 1:12300 SW 2 ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33325
Mailing Address - Country:US
Mailing Address - Phone:954-472-8587
Mailing Address - Fax:305-500-2146
Practice Address - Street 1:12300 SW 2 ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33325
Practice Address - Country:US
Practice Address - Phone:954-472-8587
Practice Address - Fax:954-437-8086
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42311207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD57708Medicare UPIN
FL64506SMedicare ID - Type Unspecified