Healthcare Provider Details

I. General information

NPI: 1780515601
Provider Name (Legal Business Name): JESUS MIGUEL HERNANDEZ RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSIDAD DE PUERTO RICO, RECINTO DE CIENCIAS MEDICAS PASEO DR. JOSE CELSO BARBOSA
SAN JUAN PR
00921
US

IV. Provider business mailing address

2654 SW 29TH CT
MIAMI FL
33133-3036
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone: 786-380-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: