Provider Demographics
NPI:1245516558
Name:HURTADO, MARIA ADELAIDA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ADELAIDA
Last Name:HURTADO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2813 KINSINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-1863
Mailing Address - Country:US
Mailing Address - Phone:305-321-5386
Mailing Address - Fax:
Practice Address - Street 1:2813 KINSINGTON CIR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33332-1863
Practice Address - Country:US
Practice Address - Phone:305-321-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 195501223G0001X
CA563741223G0001X
FLDH 19671124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No124Q00000XDental ProvidersDental Hygienist