Provider Demographics
NPI:1992923239
Name:HERNANDEZ, ISRAEL
Entity type:Individual
Prefix:MR
First Name:ISRAEL
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:FARMACIA
Other - Middle Name:
Other - Last Name:PLAZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:58 CALLE PABLO CASALS
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-3923
Mailing Address - Country:US
Mailing Address - Phone:787-834-2120
Mailing Address - Fax:
Practice Address - Street 1:58 CALLE PABLO CASALS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-3923
Practice Address - Country:US
Practice Address - Phone:787-834-2120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4015360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist