| Fort Lauderdale Dms | |
|
2000 S. Andrews Avenue Fort Lauderdale FL 33316 | |
| (954) 356-9956 | |
| (954) 356-8120 |
| Full Name | Fort Lauderdale Dms |
|---|---|
| Speciality | Dentist |
| Location | 2000 S. Andrews Avenue, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Roland Anthony Hernandez (PRESIDENT) |
| Authorized Official Contact | 9543569956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Lauderdale Dms 2000 S. Andrews Avenue Fort Lauderdale FL 33316 Ph: (954) 356-9956 | Fort Lauderdale Dms 2000 S. Andrews Avenue Fort Lauderdale FL 33316 Ph: (954) 356-9956 |
| NPI Number | 1922250703 |
|---|---|
| Provider Enumeration Date | 10/13/2008 |
| Last Update Date | 04/22/2021 |
| Medicare PECOS PAC ID | 6709054190 |
|---|---|
| Medicare Enrollment ID | O20110801000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922250703 | NPI | - | NPPES |
| 070434200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN16358 (Florida) | Primary |
| Provider Name | Roland A Hernandez |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1427259431 PECOS PAC ID: 6709054182 Enrollment ID: I20110801000146 |
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