Individual
LESLIE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
148 WHITAKER RD, LUTZ, FL 33549-7611
(813) 949-3211
Mailing address
148 WHITAKER RD, LUTZ, FL 33549-7611
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN13226
FL
Other
Enumeration date
06/27/2014
Last updated
06/27/2014
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