Provider Demographics
NPI:1992291678
Name:HERNANDEZ X-RAY CENTER LLC
Entity type:Organization
Organization Name:HERNANDEZ X-RAY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ CARABALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-320-8583
Mailing Address - Street 1:907 CALLE MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-1401
Mailing Address - Country:US
Mailing Address - Phone:787-913-0429
Mailing Address - Fax:
Practice Address - Street 1:907 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624-1401
Practice Address - Country:US
Practice Address - Phone:787-913-0429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty