Provider Demographics
NPI:1104808799
Name:HERNANDEZ, MARIA DEL CARMEN (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 372
Mailing Address - Street 2:CALLE IGNACIO MORALES ACOSTA 72
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-0372
Mailing Address - Country:US
Mailing Address - Phone:787-869-0540
Mailing Address - Fax:787-869-0540
Practice Address - Street 1:CALLE IGNACIO MORALES ACOSTA 72
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-0372
Practice Address - Country:US
Practice Address - Phone:787-869-0540
Practice Address - Fax:787-869-0540
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8352207Q00000X
PRBH0612108207Q00000X
PRDM076216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
29566OtherTUPLE S
200012OtherUTI
7190022OtherHUMANA DE PR
1083OtherAMERICAN HEALTH
26145OtherASOCIAIION MAESTROS
PE3067OtherPALIC
8006OtherIMC
400130OtherMMM
5483561457OtherMAFFRE
06992OtherCRUZ AZUEL
3608352OtherUIA
7190022OtherHUMANA DE PR
29566Medicare ID - Type Unspecified