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General NPI Number Information
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NPI Number | 1235735960
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Entity Type | Individual
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Provider Name | ANA NICOLLE HERNANDEZ ALEJANDRO OD
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Gender | Female
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | AVE. 65 DE INFANTERIA, KM. 12.3
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-769-2477
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Fax |
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Provider Business Mailing Address
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Address Line | 657 CALLE LIRIO DE PAZ LAS FLORES DE MONTEHIEDRA
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-436-0089
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 000748
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License Number State | PR
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