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Individual

DR. ILEANA FERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
430 CALLE SAN CLAUDIO, SAN JUAN, PR 00926-4222
(787) 761-0888
(787) 760-2195
Mailing address
430 CALLE SAN CLAUDIO, SAN JUAN, PR 00926-4222
(787) 761-0888
(787) 760-2195

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1621
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041282
CRUZ AZUL
PR
01
4000164
HUMANA
PR
01
41527
SSS
PR
01
660386268
MAPFRE
PR
01
660386268-02
MCS
PR
Enumeration date
09/14/2006
Last updated
07/08/2007
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