Provider Demographics
NPI:1275746562
Name:HERNANDEZ, MONICA (SW)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BO MAMEY 1 CARR. 835 KM 1.8
Mailing Address - Street 2:HC 04 BOX 5357
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-9515
Mailing Address - Country:US
Mailing Address - Phone:787-777-3535
Mailing Address - Fax:
Practice Address - Street 1:CENTRO MEDICO
Practice Address - Street 2:HOSPITAL PEDIATRICO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919-1079
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7228104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker