Healthcare Provider Details

I. General information

NPI: 1578484366
Provider Name (Legal Business Name): TATTUANNIE BORINQUEN OFFICE PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CALLE EMILIO RUIZ
SAN SEBASTIAN PR
00685-2205
US

IV. Provider business mailing address

4 CALLE EMILIO RUIZ
SAN SEBASTIAN PR
00685-2205
US

V. Phone/Fax

Practice location:
  • Phone: 787-280-2225
  • Fax: 939-666-0344
Mailing address:
  • Phone: 787-280-2225
  • Fax: 939-666-0344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNIE D HERNANDEZ
Title or Position: MEDICO GENERALISTA
Credential: MD
Phone: 787-280-2225