Healthcare Provider Details

I. General information

NPI: 1891907101
Provider Name (Legal Business Name): EMPRESAS HERNANDEZ MERCADO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CALLE BRUMBAUGH
RIO PIEDRAS PR
00925-2916
US

IV. Provider business mailing address

1055 CALLE BRUMBAUGH
RIO PIEDRAS PR
00925-2916
US

V. Phone/Fax

Practice location:
  • Phone: 787-765-3735
  • Fax: 787-765-3735
Mailing address:
  • Phone: 787-765-3735
  • Fax: 787-765-3735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number144
License Number StatePR

VIII. Authorized Official

Name: MRS. LIDIA MERCADO HERNANDEZ
Title or Position: MEDICAL TECHNOLOGIST
Credential:
Phone: 787-765-3735