Healthcare Provider Details

I. General information

NPI: 1043147036
Provider Name (Legal Business Name): HERNANDEZ AUDIOLOGY AND BALANCE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PASEO DEGETAU CARRETERA 155
OROCOVIS PR
00720
US

IV. Provider business mailing address

HC 2 BOX 8357
OROCOVIS PR
00720-9466
US

V. Phone/Fax

Practice location:
  • Phone: 787-487-6633
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: KRISTEAN X HERNANDEZ HERNANDEZ
Title or Position: PRESIDENT
Credential: AUD
Phone: 787-487-6633