Provider Demographics
NPI:1376896035
Name:HERNANDEZ, WILFRED IRVING (MD)
Entity Type:Individual
Prefix:DR
First Name:WILFRED
Middle Name:IRVING
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:LAUREL AVE 100
Mailing Address - Street 2:URB. SANTA JUANITA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-787-5151
Mailing Address - Fax:787-269-0050
Practice Address - Street 1:GALERIA PACIFICO CARR. 10 KM 85.7 SUITE 5
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-7564
Practice Address - Fax:787-878-7218
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR19539207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine