MEDICARE: SHIRLEY H. DIAZ-HERNANDEZ PHARMD

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	1835P2201X	Ambulatory Care Pharmacist	6419	PR

General Provider Information

NPI Number	:	1427591544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRLEY H. DIAZ-HERNANDEZ PHARMD

Provider Business Mailing Address
First Line	:	PO BOX 271
Second Line	:
City	:	JUNCOS
State	:	PR
Zip	:	00777-0271
Country	:	US
Telephone Number	:	787-914-2954
Fax Number	:

Provider Business Practice Location Address
First Line	:	282 AVE JESUS T PINERO
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00927-3921
Country	:	US
Telephone Number	:	787-523-3555
Fax Number	:

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

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	11/21/2016

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