Provider Demographics
NPI:1386769636
Name:HERNANDEZ, LILLIAN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 PASEO HERRADURA
Mailing Address - Street 2:PARQUE DEL RIO, ENCANTADA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6068
Mailing Address - Country:US
Mailing Address - Phone:787-748-1513
Mailing Address - Fax:
Practice Address - Street 1:97 PASEO HERRADURA
Practice Address - Street 2:PARQUE DEL RIO, ENCANTADA
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-6068
Practice Address - Country:US
Practice Address - Phone:787-748-1513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator