Provider Demographics
NPI:1811736697
Name:HERNANDEZ-GONZALEZ, IRANIS NICOLE
Entity type:Individual
Prefix:
First Name:IRANIS
Middle Name:NICOLE
Last Name:HERNANDEZ-GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CIUDAD JARDIN CAROLINA
Mailing Address - Street 2:CALLE 371 EAST ROSE
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-2224
Mailing Address - Country:US
Mailing Address - Phone:939-262-0467
Mailing Address - Fax:
Practice Address - Street 1:CIUDAD JARDIN CAROLINA
Practice Address - Street 2:CALLE 371 EAST ROSE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-2224
Practice Address - Country:US
Practice Address - Phone:939-262-0467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program