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General NPI Number Information
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NPI Number | 1316532781
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Entity Type | Individual
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Provider Name | RONALDO J HERNANDEZ ORTIZ SR.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2021
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 16 CALLE MUNOZ RIVERA
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City | VILLALBA
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State | PR
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Zip | 00766-3029
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Country | US
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Telephone | 787-847-4270
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Fax | 787-847-3057
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Provider Business Mailing Address
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Address Line | 206 CALLE AUSUBO
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City | COTO LAUREL
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State | PR
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Zip | 00780-2905
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Country | US
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Telephone | 787-467-3500
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6794
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License Number State | PR
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