Provider Demographics
NPI:1053204792
Name:HERNANDEZ, OKAERI ALDAIR (OD)
Entity type:Individual
Prefix:
First Name:OKAERI
Middle Name:ALDAIR
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 FRIENDSHIP RD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35670-3707
Mailing Address - Country:US
Mailing Address - Phone:256-565-4211
Mailing Address - Fax:
Practice Address - Street 1:1107 BELTLINE RD SE STE C
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6556
Practice Address - Country:US
Practice Address - Phone:256-822-7593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-F64152W00000X
AL156FX1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1202XEye and Vision Services ProvidersTechnician/TechnologistOptometric Technician
No152W00000XEye and Vision Services ProvidersOptometrist