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General NPI Number Information
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NPI Number | 1881026201
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Entity Type | Individual
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Provider Name | WILLIAM HERNANDEZ III
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Gender | Male
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | CALLE 1 BLOQUE 2 751 URB PASEO REAL
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City | ARECIBO
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State | PR
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Zip | 00612-0000
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Country | US
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Telephone | 787-502-4413
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 827
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City | BARCELONETA
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State | PR
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Zip | 00617-0827
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Country | US
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Telephone | 787-502-4413
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 660807512
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License Number State | PR
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