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General NPI Number Information
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NPI Number | 1982484713
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Entity Type | Individual
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Provider Name | SOMAYRA HERNANDEZ DIAZ PA
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Gender | Female
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Dates
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Enumeration Date | 09/29/2023
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 315 AVE LAURO PINERO
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City | CEIBA
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State | PR
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Zip | 00735-3100
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Country | US
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Telephone | 787-613-0243
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5831
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City | CAGUAS
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State | PR
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Zip | 00726-5831
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Country | US
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Telephone | 787-613-0243
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 001310-P.A.
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License Number State | PR
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