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General NPI Number Information
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NPI Number | 1316562382
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Entity Type | Individual
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Provider Name | CRISTAL IMAR HERNANDEZ HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 7125 13TH PL NW
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City | WASHINGTON
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State | DC
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Zip | 20012-2351
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Country | US
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Telephone | 202-545-2532
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Fax | 202-545-2543
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Provider Business Mailing Address
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Address Line | 7125 13TH PL NW
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City | WASHINGTON
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State | DC
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Zip | 20012-2351
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Country | US
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Telephone | 787-329-2499
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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 | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | MD210002756
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License Number State | DC
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