Provider Demographics
NPI:1235165143
Name:HERNANDEZ, RAYMOND JR
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:HERNANDEZ
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US ARMY HEALTH CLINIC, VICENZA
Mailing Address - Street 2:UNIT 31403, BOX 13
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09630
Mailing Address - Country:IT
Mailing Address - Phone:39044-471-8010
Mailing Address - Fax:39044-471-6670
Practice Address - Street 1:CMR 427 BOX 2953
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09630
Practice Address - Country:IT
Practice Address - Phone:39340-762-4851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX252027163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health