Healthcare Provider Details

I. General information

NPI: 1235146606
Provider Name (Legal Business Name): HECTOR R BIRD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 CALLE LUCHETTI HORIZON HOUSE (APT. 4)
SAN JUAN PR
00907-1963
US

IV. Provider business mailing address

1300 CALLE LUCHETTI HORIZON HOUSE (APT. 4)
SAN JUAN PR
00907-1963
US

V. Phone/Fax

Practice location:
  • Phone: 787-241-5050
  • Fax:
Mailing address:
  • Phone: 787-241-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number101402
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number101402
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: