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General NPI Number Information
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NPI Number | 1114404472
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Entity Type | Individual
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Provider Name | MARISOL HERNANDEZ HEALTH EDUCATOR MAST
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Gender | Female
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | CARR 921 KM 2.8 BO TEJAS SECTOR ALTURAS DE TEJAS 117
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City | LAS PIEDRAS
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State | PR
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Zip | 00771
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Country | US
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Telephone | 787-598-2450
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 876
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City | LAS PIEDRAS
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State | PR
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Zip | 00771-0876
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Country | US
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Telephone | 787-598-2450
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 5069
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License Number State | PR
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