Provider Demographics
NPI:1063283950
Name:HERNANDEZ BARRETO, MARINELYS
Entity type:Individual
Prefix:
First Name:MARINELYS
Middle Name:
Last Name:HERNANDEZ BARRETO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 61072
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-9074
Mailing Address - Country:US
Mailing Address - Phone:787-910-8950
Mailing Address - Fax:
Practice Address - Street 1:AVE. HOSTOS 410 CARR.2 BO. SABALOS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-910-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program