Provider Demographics
NPI:1194333492
Name:HERNANDEZ-APONTE, PEDRO W (BSW)
Entity type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:W
Last Name:HERNANDEZ-APONTE
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EXT. VILLA RICA
Mailing Address - Street 2:CALLE 13 U8
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-461-6698
Mailing Address - Fax:
Practice Address - Street 1:U8 CALLE 13
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5141
Practice Address - Country:US
Practice Address - Phone:787-461-6698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRS01230516390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty