Healthcare Provider Details

I. General information

NPI: 1437784733
Provider Name (Legal Business Name): REINALDO HERNANDEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO DE PUERTO RICO BARRIO MONACILLOS
SAN JUAN PR
00935-0001
US

IV. Provider business mailing address

474 CALLE DE DIEGO APT 26
SAN JUAN PR
00923-3135
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-0101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number24388
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24388
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: