MEDICARE: DR. WILLIAM HERNANDEZ VERA 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
1	208D00000X	General Practice Physician	16624	PR

General Provider Information

NPI Number	:	1417044496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM HERNANDEZ VERA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1170
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602-1170
Country	:	US
Telephone Number	:	787-252-1432
Fax Number	:

Provider Business Practice Location Address
First Line	:	1051 CALLE 3 SE
Second Line	:	APT 306
City	:	SAN JUAN
State	:	PR
Zip	:	00921-3000
Country	:	US
Telephone Number	:	787-792-0633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	07/08/2007

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