| Organization Name: | JOSE HERNANDEZ VERA-MEDICINA GENERAL,CSP |
| NPI Number: | 1184034332 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSE HERNANDEZ (PRESIDENT) |
| Mailing Address: | 15 Calle Dr Basora N Mayaguez |
| State: | PR US |
| Postal Code: | 006804833 |
| Phone Number: | 7878340101 |
| Fax Number: | |
| NPI Enumeration Date: | 04/28/2014 |
| NPI Last Update Date: | 04/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 16580 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |