Healthcare Provider Details

I. General information

NPI: 1912938507
Provider Name (Legal Business Name): CARMEN N HERNANDEZ ROJAS TR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 848 KM. 3.0 BO. SAN ANTON
CAROLINA PR
00987
US

IV. Provider business mailing address

1016 CALLE LUIS PARDO URB. SAN MARTIN
SAN JUAN PR
00924-4428
US

V. Phone/Fax

Practice location:
  • Phone: 787-276-0210
  • Fax:
Mailing address:
  • Phone: 787-757-5119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number727
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: