Healthcare Provider Details

I. General information

NPI: 1992291678
Provider Name (Legal Business Name): HERNANDEZ X-RAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 CALLE MUNOZ RIVERA
PENUELAS PR
00624-1401
US

IV. Provider business mailing address

907 CALLE MUNOZ RIVERA
PENUELAS PR
00624-1401
US

V. Phone/Fax

Practice location:
  • Phone: 787-913-0429
  • Fax:
Mailing address:
  • Phone: 787-913-0429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: NORBERTO RODRIGUEZ CARABALLO
Title or Position: PRESIDENT / OWNER
Credential:
Phone: 787-320-8583