Provider Demographics
NPI:1487095832
Name:HERNANDEZ, JOSE OSCAR SR (MD)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:OSCAR
Last Name:HERNANDEZ
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-0014
Mailing Address - Country:US
Mailing Address - Phone:787-412-1623
Mailing Address - Fax:
Practice Address - Street 1:SERGIO CUEVAS BUSTAMANTE STREET #550, AVE DOMENECH
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-758-8383
Practice Address - Fax:787-474-7615
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18831208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice