Healthcare Provider Details
I. General information
NPI: 1285607101
Provider Name (Legal Business Name): HERNANDEZ ALONSO MEDICAL OFFICES P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/10/2006
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 CALLE DUARTE URB. FLORAL PARK
SAN JUAN PR
00917
US
IV. Provider business mailing address
PMB #394 5900 ISLA VERDE AVE. L-2
CAROLINA PR
00979-4901
US
V. Phone/Fax
- Phone: 787-759-6909
- Fax: 787-282-0884
- Phone: 787-307-3399
- Fax: 787-701-2671
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | 11034 |
| License Number State | PR |
VIII. Authorized Official
Name: DR.
VICTOR
A
HERNANDEZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-980-8268