Provider Demographics
NPI:1720696735
Name:HERNANDEZ-ORTIZ, ANA CAROLINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:CAROLINA
Last Name:HERNANDEZ-ORTIZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1593 SW 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5706
Mailing Address - Country:US
Mailing Address - Phone:954-628-6552
Mailing Address - Fax:
Practice Address - Street 1:6720 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-7544
Practice Address - Country:US
Practice Address - Phone:954-541-9796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL263101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice