1477551984 NPI number — BENITO HERNANDEZ MD

Table of content: BENITO HERNANDEZ MD (NPI 1477551984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477551984 NPI number — BENITO HERNANDEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERNANDEZ
Provider First Name:
BENITO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1477551984
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8731
Provider Second Line Business Mailing Address:
CALLE J ESQ. CALLE B OH. 106 EDIL. MED. HNAS DAUILA
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960-8731
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-740-0066
Provider Business Mailing Address Fax Number:
787-269-3020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE J ESQ. CALLE B OH. 106 EDIL. MED. HNAS DAUILA
Provider Second Line Business Practice Location Address:
CALLE J ESQ. CALLE B OH. 106 EDIL. MED. HNAS DAUILA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
00960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-740-0066
Provider Business Practice Location Address Fax Number:
787-269-3020
Provider Enumeration Date:
07/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  5076 , 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)

  • Identifier: 1060 . This is a "INTERNATIONAL MEDICAL CAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: PE0133 . This is a "PALIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 068118 . This is a "SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6200077 . This is a "HUMAN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6200077 . This is a "HUMANA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 068118 . This is a "C.A," identifier . This identifiers is of the category "OTHER".
  • Identifier: 209094 . This is a "UTI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2808 . This is a "AMERICAN HEALTH CARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com