MEDICARE: HERNANDEZ-PONS HEMATOLOGY ONCOLOGY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician

General Provider Information

NPI Number	:	1235800327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERNANDEZ-PONS HEMATOLOGY ONCOLOGY LLC

Provider Business Mailing Address
First Line	:	369 CALLE SAN CLAUDIO UNIT 261146
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-0645
Country	:	US
Telephone Number	:	787-206-1071
Fax Number	:

Provider Business Practice Location Address
First Line	:	1418 CALLE AMERICO SALAS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00909-2139
Country	:	US
Telephone Number	:	787-523-6944
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. EDUARDO JOEL HERNANDEZ-PONS
Credential	:	MD
Telephone Number	:	787-206-1061

Provider Enumeration Date	:	09/28/2021
Last Update Date	:	07/18/2022

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