Provider Demographics
NPI:1003028309
Name:HERNANDEZ, NORBERT SR (OD)
Entity Type:Individual
Prefix:DR
First Name:NORBERT
Middle Name:
Last Name:HERNANDEZ
Suffix:SR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 2565
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-9549
Mailing Address - Country:US
Mailing Address - Phone:787-829-9933
Mailing Address - Fax:787-829-9933
Practice Address - Street 1:35 CALLE SAN JOAQUIN STE 1
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601-2135
Practice Address - Country:US
Practice Address - Phone:787-829-9933
Practice Address - Fax:787-829-9933
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0477152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR050103Medicare ID - Type Unspecified