Provider Demographics
NPI:1386947927
Name:HERNANDEZ, CARLA ALEJANDRA (BSN)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:ALEJANDRA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JS1 CALLE ASUNCION BOBADILLA
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3602
Mailing Address - Country:US
Mailing Address - Phone:787-903-3439
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA CAMPO RICO
Practice Address - Street 2:GP13 LOCAL2
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-210-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR91833-G163WG0000X
PR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No171M00000XOther Service ProvidersCase Manager/Care Coordinator