Healthcare Provider Details

I. General information

NPI: 1053228932
Provider Name (Legal Business Name): FELIX J. HERNANDEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 2 BOX 7192
COMERIO PR
00782-9626
US

IV. Provider business mailing address

HC 2 BOX 7192
COMERIO PR
00782-9626
US

V. Phone/Fax

Practice location:
  • Phone: 939-225-1865
  • Fax:
Mailing address:
  • Phone: 939-225-1865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number17753
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: