Provider Demographics
NPI:1477946382
Name:HERNANDEZ, ANA MARIBEL SR (O)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:MARIBEL
Last Name:HERNANDEZ
Suffix:SR
Gender:F
Credentials:O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A5 CALLE15
Mailing Address - Street 2:TOA ALTA HEIGHTS
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-344-9706
Mailing Address - Fax:
Practice Address - Street 1:A-5 CALLE 15
Practice Address - Street 2:TOA ALTA HEIGHTS
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-0000
Practice Address - Country:US
Practice Address - Phone:787-344-9706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9744247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other