Basic Information
| Provider Information | |||||||||
| NPI: | 1861947137 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERNANDEZ-CORDERO | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | ZOE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | A19 CALLE 4 | ||||||||
| Address2: | URB. PRADO ALTO | ||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009663033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873429118 | ||||||||
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| Practice Location | |||||||||
| Address1: | EDIFICIO 36 CALLE BARBOSA ESQUINA ROSSY | ||||||||
| Address2: | |||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773535 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2016 | ||||||||
| LastUpdateDate: | 07/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 21788 | PR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RE0101X | 21788 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.