Healthcare Provider Details

I. General information

NPI: 1174989644
Provider Name (Legal Business Name): DRA. MARIA A. HERNANDEZ IGLESIAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310B CALLE CLEMSON UNIVERSITY GARDENS
SAN JUAN PR
00927-4022
US

IV. Provider business mailing address

AB12 CALLE NEBRASKA CAGUAS NORTE
CAGUAS PR
00725-2265
US

V. Phone/Fax

Practice location:
  • Phone: 787-565-3329
  • Fax: 787-258-8687
Mailing address:
  • Phone: 787-258-8686
  • Fax: 787-258-8687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number307
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number307
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number307
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number307
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number307
License Number StatePR
# 6
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number307
License Number StatePR
# 7
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License Number307
License Number StatePR
# 8
Primary TaxonomyN
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number307
License Number StatePR
# 9
Primary TaxonomyN
Taxonomy Code156FX1101X
TaxonomyOphthalmic Assistant
License Number307
License Number StatePR
# 10
Primary TaxonomyN
Taxonomy Code156FX1201X
TaxonomyOptometric Assistant Technician
License Number307
License Number StatePR
# 11
Primary TaxonomyN
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License Number307
License Number StatePR
# 12
Primary TaxonomyN
Taxonomy Code156FX1700X
TaxonomyOcularist
License Number307
License Number StatePR
# 13
Primary TaxonomyN
Taxonomy Code156FX1900X
TaxonomyOrthoptist
License Number307
License Number StatePR
# 14
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number307
License Number StatePR

VIII. Authorized Official

Name: DR. MARIA A. HERNANDEZ IGLESIAS
Title or Position: CERTIFY OPTOMETRIST/OWNER
Credential: O.D.
Phone: 787-565-3329