Individual
ILLIAD E HERNANDEZ LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
T M
Contact information
Practice address
85 CALLE DON CHEMARY, MOCA, PR 00676
(787) 877-1895
(787) 877-1895
Mailing address
PO BOX 357, MOCA, PR 00676
(787) 877-1895
(787) 877-1895
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
610
PR
Other
Enumeration date
03/06/2008
Last updated
03/07/2008
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