Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 18102 | PR |
N | 111NI0900X | Internist | 18102 | PR |
Y | 207RN0300X | Nephrologist | 18102 | PR |
N | 208D00000X | General Practice Physician | 18102 | PR |
NPI | 1043514110 |
---|---|
Provider Name | Dr. Michelle Cofan Hernandez |
First Address | Bayamon, PR 00956-4822 |
Second Address | Mayaguez, PR 00682-6353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2011 |
Last Update Date | 04/08/2020 |