Organization
HERNANDEZ LEA PLAZA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODOLFO LEA PLAZA DDS (OWNER/DENTIST)
(786) 266-5383
Entity
Organization
Contact information
Practice address
141 CRANDON BLVD APT 433, KEY BISCAYNE, FL 33149-1552
(786) 266-5383
Mailing address
141 CRANDON BLVD APT 433, KEY BISCAYNE, FL 33149-1552
(786) 266-5383
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN19240
FL
122300000X
Dentist
Primary
DN20264
FL
Other
Enumeration date
02/05/2014
Last updated
03/13/2014
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