Basic Information
| Provider Information | |||||||||
| NPI: | 1871571695 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HERNANDEZ | ||||||||
| FirstName: | NILDA | ||||||||
| MiddleName: | IVONNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | F7 VIA SAN PAOLO | ||||||||
| Address2: | URB. MONTE ALVERNIA | ||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009696848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877906129 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1451 AVE ASHFORD | ||||||||
| Address2: | ASHFORD PRESBYTERIAN HOSPITAL | ||||||||
| City: | CONDADO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009071511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877212160 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 6433 | PR | Y | Other Service Providers | Specialist |
No ID Information.