Organization
ILLIAD E HERNANDEZ LOPEZ
Active
Other names
LABORATORIO CLINICO HERNANDEZ
Organization subpart
No
Provider details
NPI number
Authorized official
ILLIAD E HERNANDEZ (MT)
(787) 877-1895
Entity
Organization
Contact information
Practice address
85 CALLE DON CHEMARY, MOCA, PR 00676-4120
(787) 877-1895
(787) 877-1895
Mailing address
PO BOX 357, MOCA, PR 00676-0357
(787) 877-1895
(787) 877-1895
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
610
PR
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030836
—
PR
Enumeration date
01/05/2007
Last updated
09/23/2020
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