MEDICARE: DR. JOSE RAFAEL HERNANDEZ PHD

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	103T00000X	Psychologist	00078	PR

General Provider Information

NPI Number	:	1821285297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE RAFAEL HERNANDEZ PHD

Provider Business Mailing Address
First Line	:	I2 CALLE 8
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725-2088
Country	:	US
Telephone Number	:	787-743-1703
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 ST I-2
Second Line	:	EXT SAN ANTONIO
City	:	CAGUAS
State	:	PR
Zip	:	00725-2088
Country	:	US
Telephone Number	:	787-743-1703
Fax Number	:

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

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	03/20/2018

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