Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN18209 | FL |
NPI | 1043409733 |
---|---|
Provider Name | Linnette Hernandez |
First Address | Orlando, FL 32827-5764 |
Second Address | Orlando, FL 32827-5764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2007 |
Last Update Date | 26/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002316000 | (05) | FL |