1033524285 NPI number — DR ANTONIO HERNANDEZ LLC

Table of content: MRS. VICTORIA CAMPOS SCHLOTZHAUER RPH. (NPI 1922109040)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033524285 NPI number — DR ANTONIO HERNANDEZ LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR ANTONIO HERNANDEZ LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033524285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE 6 URB LA MILAGROSA
Provider Second Line Business Mailing Address:
CENTRO COMERCIAL LA MILAGROSA OF5
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00959
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-779-4049
Provider Business Mailing Address Fax Number:
787-785-7125

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
F19 CALLE ISLA NENA
Provider Second Line Business Practice Location Address:
REPARTO FLAMINGO
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959-4936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-779-4049
Provider Business Practice Location Address Fax Number:
787-785-7125
Provider Enumeration Date:
06/26/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HERNANDEZ
Authorized Official First Name:
ANTONIO
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
787-779-4049

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  2505 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)