Provider Demographics
NPI:1356174650
Name:CARDERO HECHAVARRIA, YUNIER
Entity type:Individual
Prefix:
First Name:YUNIER
Middle Name:
Last Name:CARDERO HECHAVARRIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11600 GLADIOLUS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4565
Mailing Address - Country:US
Mailing Address - Phone:786-403-0085
Mailing Address - Fax:
Practice Address - Street 1:4208 SE 19TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-5480
Practice Address - Country:US
Practice Address - Phone:786-403-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29541122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist