Doctor Name: | DR. WANDA LIZ HERNANDEZ |
NPI Number: | 1538392980 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 17749 |
Business Practice Address: | 116 Ave Dr Susoni Hatillo, PR - 006591847 |
Business Phone Number: | 7878984190 |
Business Fax Number: | 7872623984 |
Mailing Address: | Po Box 907, HATILLO |
State: | PR |
Postal Code: | 006590907 |
Phone Number: | 7878984190 |
Fax Number: | 7872623984 |
NPI Enumeration Date: | 09/02/2009 |
NPI Last Update Date: | 03/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17749 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |