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General NPI Number Information
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NPI Number | 1386075232
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Entity Type | Individual
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Provider Name | ELIZABETH HERNANDEZ MT
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Gender | Female
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | CARR. 149 KM12.2
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City | CIALES
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State | PUERTO RICO
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Zip | 00638
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Country | UM
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Telephone | 787-871-0601
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Fax | 787-871-3960
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Provider Business Mailing Address
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Address Line | URB. JARDINES DE VEGA BAJA 292 CALLE JARDIN DEL CARIBE
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City | VEGA BAJA
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State | PUERTO RICO
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Zip | 00693
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Country | UM
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Telephone | 787-871-0601
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Fax | 787-871-3960
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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 | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | 3662
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License Number State | PR
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