Healthcare Provider Details

I. General information

NPI: 1629037205
Provider Name (Legal Business Name): JUAN V HERNANDEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 ASHFORD AVE CONDADO HOSPITAL ASHFORD
SAN JUAN PR
00907
US

IV. Provider business mailing address

PO BOX 3619
GUAYNABO PR
00970-3619
US

V. Phone/Fax

Practice location:
  • Phone: 787-722-6004
  • Fax: 787-722-6003
Mailing address:
  • Phone: 787-999-0753
  • Fax: 787-999-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number14427
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number14427
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: