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General NPI Number Information
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NPI Number | 1912961970
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Entity Type | Individual
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Provider Name | JOSE MIGUEL HERNANDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 12/01/2008
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Provider Practice Location Address
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Address Line | BO. MONACILLO CARR 22 PASEO DR. JOSE CELSO BARBOSA
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City | SAN JUAN
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State | PR
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Zip | 00935-0001
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Country | US
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Telephone | 787-777-3535
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Fax |
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Provider Business Mailing Address
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Address Line | A15 CALLE 7 URB. BRAULIO DUENO COLON
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City | BAYAMON
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State | PR
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Zip | 00959-5426
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Country | US
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Telephone | 787-787-4330
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4769
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License Number State | PR
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