MEDICARE: MRS. MONICA HERNANDEZ S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	7228	PR

General Provider Information

NPI Number	:	1275746562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONICA HERNANDEZ S.W.

Provider Business Mailing Address
First Line	:	BO MAMEY 1 CARR. 835 KM 1.8
Second Line	:	HC 04 BOX 5357
City	:	GUAYNABO
State	:	PR
Zip	:	00971-9515
Country	:	US
Telephone Number	:	787-777-3535
Fax Number	:

Provider Business Practice Location Address
First Line	:	CENTRO MEDICO
Second Line	:	HOSPITAL PEDIATRICO
City	:	SAN JUAN
State	:	PR
Zip	:	00919-1079
Country	:	US
Telephone Number	:	787-777-3535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/08/2007

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