Healthcare Provider Details

I. General information

NPI: 1831590983
Provider Name (Legal Business Name): YANIRA HERNANDEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COND. GALERIA APT. 702 #201 AVE. ARTERIAL HOSTOS
SAN JUAN PR
00918
US

IV. Provider business mailing address

COND. GALERIA APT. 702 #201 AVE. ARTERIAL HOSTOS
SAN JUAN PR
00918
US

V. Phone/Fax

Practice location:
  • Phone: 787-397-2597
  • Fax:
Mailing address:
  • Phone: 787-397-2597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number18864
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: