=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275671430
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARIA A. HERNANDEZ, M.D. LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2007
-----------------------------------------------------
Last Update Date | 01/24/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 129 UNIVERSITY BLVD SUITE E
-----------------------------------------------------
City | HARRISONBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22801-3751
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-442-6144
-----------------------------------------------------
Fax | 540-442-6145
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 129 UNIVERSITY BLVD SUITE E
-----------------------------------------------------
City | HARRISONBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22801-3751
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-442-6144
-----------------------------------------------------
Fax | 540-442-6145
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. MARIA A. HERNANDEZ
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 540-442-6144
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 0101231276
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------