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General NPI Number Information
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NPI Number | 1154514594
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Entity Type | Organization
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Legal Business Name | EDGAR C HERNANDEZ PSC NEUROLOGY
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 369 CALLE DE DIEGO SUITE 607 TORRE SAN FRANCISCO
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City | SAN JUAN
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State | PR
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Zip | 00923
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Country | US
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Telephone | 787-764-9560
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Fax | 787-771-6161
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Provider Business Mailing Address
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Address Line | 369 CALLE DE DIEGO SUITE 607 TORRE MEDICA SAN FRANCISCO
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City | SAN JUAN
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State | PR
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Zip | 00923-3003
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Country | US
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Telephone | 787-764-9560
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Fax | 787-771-6161
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDGAR C HERNANDEZ VIERA
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Credential | MD
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Telephone | 787-764-9560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 13207
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License Number State | PR
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