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General NPI Number Information
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NPI Number | 1043499445
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Entity Type | Individual
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Provider Name | DR. JOHANNY HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 140 AVE LAS CUMBRES
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City | GUAYNABO
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State | PR
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Zip | 00969-5523
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Country | US
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Telephone | 787-720-5050
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Fax |
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Provider Business Mailing Address
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Address Line | COND JARDINES DE MONTEHIEDRA AVE. LOS ROMEROS 1500 APT. 1007
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City | SAN JUAN
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State | PR
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Zip | 00926-7011
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Country | US
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Telephone | 787-734-0459
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 16879
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16879
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License Number State | PR
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