Healthcare Provider Details

I. General information

NPI: 1629559323
Provider Name (Legal Business Name): HERA GINECOLOGIA Y OBSTETRICIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 05/31/2020
Certification Date: 05/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 SAN JORGE MEDICAL BUILDING SUITE 405
SANTURCE PR
00912
US

IV. Provider business mailing address

252 SAN JORGE MEDICAL BUILDING SUITE 405
SANTURCE PR
00912
US

V. Phone/Fax

Practice location:
  • Phone: 787-727-1000
  • Fax:
Mailing address:
  • Phone: 787-727-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StatePR

VIII. Authorized Official

Name: MRS. MARIOLA LLINAS MESSEGUER
Title or Position: CORPORATION PRESIDENT
Credential: MD
Phone: 787-408-2678