1477946382 NPI number — MRS. ANA MARIBEL HERNANDEZ SR. O

Table of content: MRS. ANA MARIBEL HERNANDEZ SR. O (NPI 1477946382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477946382 NPI number — MRS. ANA MARIBEL HERNANDEZ SR. O

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERNANDEZ
Provider First Name:
ANA
Provider Middle Name:
MARIBEL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
SR.
Provider Credential Text:
O
Provider Gender Code:
F

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:
1477946382
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
A5 CALLE15
Provider Second Line Business Mailing Address:
TOA ALTA HEIGHTS
Provider Business Mailing Address City Name:
TOA ALTA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00953
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-344-9706
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
A-5 CALLE 15
Provider Second Line Business Practice Location Address:
TOA ALTA HEIGHTS
Provider Business Practice Location Address City Name:
TOA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00953-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-344-9706
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/17/2015

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: 247200000X , with the licence number:  9744 , 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)





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