1174989644 NPI number — DRA. MARIA A. HERNANDEZ IGLESIAS

Table of content: (NPI 1174989644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174989644 NPI number — DRA. MARIA A. HERNANDEZ IGLESIAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRA. MARIA A. HERNANDEZ IGLESIAS
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:
CENTRO OFTALMICO DRA. MARIA A. HERNANDEZ IGLESIAS
Provider Other Organization Name Type Code:
3
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:
1174989644
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
AB12 CALLE NEBRASKA
Provider Second Line Business Mailing Address:
CAGUAS NORTE
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00725-2265
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-258-8686
Provider Business Mailing Address Fax Number:
787-258-8687

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310B CALLE CLEMSON
Provider Second Line Business Practice Location Address:
UNIVERSITY GARDENS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00927-4022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-565-3329
Provider Business Practice Location Address Fax Number:
787-258-8687
Provider Enumeration Date:
01/13/2016

Additional Information

Authorized Official

Authorized Official Last Name:
HERNANDEZ IGLESIAS
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
CERTIFY OPTOMETRIST/OWNER
Authorized Official Telephone Number:
787-565-3329

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WC0802X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WL0500X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WP0200X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156F00000X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FC0800X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FC0801X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1100X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1101X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1201X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1202X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1700X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1800X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 156FX1900X , with the licence number: 307 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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