Provider Demographics
NPI:1285162487
Name:HERNANDEZ MEDINA, DALIA CRISTINA (MD)
Entity type:Individual
Prefix:
First Name:DALIA
Middle Name:CRISTINA
Last Name:HERNANDEZ MEDINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 33102
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00933-3102
Mailing Address - Country:US
Mailing Address - Phone:787-296-9906
Mailing Address - Fax:412-293-3563
Practice Address - Street 1:7 C WASHINGTON
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-296-9906
Practice Address - Fax:412-293-3563
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR21286207VG0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21286OtherPR MEDICARE LICENSE