MEDICARE: LUIS R HERNANDEZ-COTT M.D.

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	207W00000X	Ophthalmology Physician	6067	PR

General Provider Information

NPI Number	:	1912903865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS R HERNANDEZ-COTT M.D.

Provider Business Mailing Address
First Line	:	68 CALLE SANTA CRUZ
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00961-7031
Country	:	US
Telephone Number	:	787-798-3782
Fax Number	:	787-798-0313

Provider Business Practice Location Address
First Line	:	68 CALLE SANTA CRUZ
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00961-7031
Country	:	US
Telephone Number	:	787-798-3782
Fax Number	:	787-798-0313

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	07/08/2007

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