Provider Demographics
NPI:1326002528
Name:GRAULAU-HERNANDEZ, CARMEN A (MD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:A
Last Name:GRAULAU-HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 CALLE PERSEO
Mailing Address - Street 2:CONDOMINIO CENTRO DE ALTAMIRA APT. 5-B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4204
Mailing Address - Country:US
Mailing Address - Phone:787-781-4158
Mailing Address - Fax:787-775-0093
Practice Address - Street 1:501 CALLE PERSEO
Practice Address - Street 2:CONDOMINIO CENTRO DE ALTAMIRA APT. 5-B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4204
Practice Address - Country:US
Practice Address - Phone:787-781-4158
Practice Address - Fax:787-775-0093
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6145174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist