Provider Demographics
NPI:1871571695
Name:HERNANDEZ, NILDA IVONNE (MD)
Entity type:Individual
Prefix:DR
First Name:NILDA
Middle Name:IVONNE
Last Name:HERNANDEZ
Suffix:
Gender:F
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:F7 VIA SAN PAOLO
Mailing Address - Street 2:URB. MONTE ALVERNIA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-6848
Mailing Address - Country:US
Mailing Address - Phone:787-790-6129
Mailing Address - Fax:
Practice Address - Street 1:1451 AVE ASHFORD
Practice Address - Street 2:ASHFORD PRESBYTERIAN HOSPITAL
Practice Address - City:CONDADO
Practice Address - State:PR
Practice Address - Zip Code:00907-1511
Practice Address - Country:US
Practice Address - Phone:787-721-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6433174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD99598Medicare UPIN
PR98168Medicare ID - Type Unspecified