MEDICARE: DR. HECTOR L BANCHS MD

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	207RC0000X	Cardiovascular Disease Physician	6527	PR

General Provider Information

NPI Number	:	1467457929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HECTOR L BANCHS MD

Provider Business Mailing Address
First Line	:	497 AVE EMILIANO POL
Second Line	:	STE 80
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5602
Country	:	US
Telephone Number	:	787-757-8780
Fax Number	:	787-276-9174

Provider Business Practice Location Address
First Line	:	4AS1 VIA LETICIA
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00983-4801
Country	:	US
Telephone Number	:	787-757-8780
Fax Number	:	787-276-9174

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	09/08/2010

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