Provider Demographics
NPI:1871539916
Name:HERNANDEZ, MARGARITA L (PSYD)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:L
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. ALTAVISTA I
Mailing Address - Street 2:APT 1A CARR.833
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-649-6657
Mailing Address - Fax:
Practice Address - Street 1:954 AVE PONCE DE LEON
Practice Address - Street 2:MIRAMAR PLAZA #603
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-649-6657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2551103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2092358Medicare UPIN