Provider Demographics
NPI:1902220700
Name:NILO A. HERNANDEZ JR., DDS, PA
Entity Type:Organization
Organization Name:NILO A. HERNANDEZ JR., DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-282-5296
Mailing Address - Street 1:6280 SUNSET DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4827
Mailing Address - Country:US
Mailing Address - Phone:305-282-5296
Mailing Address - Fax:
Practice Address - Street 1:6280 SUNSET DR
Practice Address - Street 2:SUITE 401
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4827
Practice Address - Country:US
Practice Address - Phone:305-282-5296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN12716122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty