Healthcare Provider Details

I. General information

NPI: 1124003116
Provider Name (Legal Business Name): AMAURY HERNANDEZ FLORES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE AMERICO MIRANDA #19
SAN JUAN PR
00926
US

IV. Provider business mailing address

U19 CALLE LAREDO VISTA BELLA
BAYAMON PR
00956-4829
US

V. Phone/Fax

Practice location:
  • Phone: 787-786-1031
  • Fax: 787-251-4518
Mailing address:
  • Phone: 787-786-1031
  • Fax: 787-251-4518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number6750
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: