Provider Demographics
NPI:1558663203
Name:HERNANDEZ HERNANDEZ, MARCOS JAVIER (MD)
Entity type:Individual
Prefix:
First Name:MARCOS
Middle Name:JAVIER
Last Name:HERNANDEZ HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:SABANA HOYOS
Mailing Address - State:PR
Mailing Address - Zip Code:00688-0959
Mailing Address - Country:US
Mailing Address - Phone:787-597-9097
Mailing Address - Fax:
Practice Address - Street 1:HC 01 BOX 3243
Practice Address - Street 2:
Practice Address - City:SABANA HOYOS
Practice Address - State:PR
Practice Address - Zip Code:00688
Practice Address - Country:US
Practice Address - Phone:787-597-9097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18096208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice