Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 11084 | PR |
NPI | 1023112141 |
---|---|
Provider Name | Hector M Hernandez Alvarez SR. |
First Address | San Juan, PR 00912-3301 |
Second Address | San Juan, PR 00909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C84468 | (02) |