Provider Demographics
NPI:1457986424
Name:DR. CHRISTINA S. HERNANDEZ, DMD, PA
Entity Type:Organization
Organization Name:DR. CHRISTINA S. HERNANDEZ, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:SOFIA
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-402-1478
Mailing Address - Street 1:12280 MIRAMAR BLVD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025
Mailing Address - Country:US
Mailing Address - Phone:787-402-1478
Mailing Address - Fax:
Practice Address - Street 1:12280 MIRAMAR BLVD
Practice Address - Street 2:SUITE #2
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3302
Practice Address - Country:US
Practice Address - Phone:787-402-1478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty