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General NPI Number Information
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NPI Number | 1225080880
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Entity Type | Individual
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Provider Name | GIOVAN E HERNANDEZ LEBRON MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | GRUPO MEDICO SAMARITANO BARRIO BARRAZAS CARR 182 KM 3
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City | CAROLINA
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State | PR
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Zip | 00981-0000
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Country | US
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Telephone | 787-661-1070
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Fax |
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Provider Business Mailing Address
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Address Line | URB CUIDAD JARDIN 51 CALLE SIEMPREVIVA
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City | GURABO
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State | PR
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Zip | 00778-0000
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Country | US
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Telephone |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 13955
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License Number State | PR
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