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NPI Code Detail

MEDICARE: DR. RAFAEL ANTONIO HERNANDEZ M.D.

MEDICARE: DR. RAFAEL ANTONIO HERNANDEZ M.D.
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
1208D00000XGeneral Practice Physician14685PR

General Provider Information

NPI Number : 1265520902
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAFAEL ANTONIO HERNANDEZ M.D.
Provider Business Mailing Address
First Line : URB. STELLA
Second Line : CALLE B # C-13
City : GUAYANILLA
State : PR
Zip : 00656-0000
Country : US
Telephone Number : 787-835-6730
Fax Number :
Provider Business Practice Location Address
First Line : 8 CALLE COLON PACHECO
Second Line :
City : SALINAS
State : PR
Zip : 00751-3344
Country : US
Telephone Number : 787-824-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 03/07/2009

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