Healthcare Provider Details

I. General information

NPI: 1386136059
Provider Name (Legal Business Name): IVONNE ESTHER HERNANDEZ CASTRO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AVE LAUREL
BAYAMON PR
00956-4816
US

IV. Provider business mailing address

CALLE COLORADO Y14 URB EXTENSION DE PARKVILLE
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-787-5151
  • Fax:
Mailing address:
  • Phone: 787-600-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number35883-R
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number23152
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number35720-R
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number23-152
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number23-152
License Number StatePR
# 7
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number34814
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: