Provider Demographics
NPI:1295861284
Name:HERNANDEZ-GONZALEZ, LIZA M (MD)
Entity Type:Individual
Prefix:DR
First Name:LIZA
Middle Name:M
Last Name:HERNANDEZ-GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:640 AVE ANDALUCIA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-5311
Mailing Address - Country:US
Mailing Address - Phone:787-957-5553
Mailing Address - Fax:787-957-5510
Practice Address - Street 1:640 AVE ANDALUCIA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-5311
Practice Address - Country:US
Practice Address - Phone:787-957-5553
Practice Address - Fax:787-957-5710
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR159782081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine