Healthcare Provider Details

I. General information

NPI: 1972433894
Provider Name (Legal Business Name): EMMANUEL HERNANDEZ MEXSC, MPHE, CHES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HW4 CALLE JOAQUIN BURSET
TOA BAJA PR
00949-3736
US

IV. Provider business mailing address

HW4 CALLE JOAQUIN BURSET
TOA BAJA PR
00949-3736
US

V. Phone/Fax

Practice location:
  • Phone: 787-226-9556
  • Fax:
Mailing address:
  • Phone: 787-226-9556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number1121
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: