Provider Demographics
NPI:1528034550
Name:HERNANDEZ, LINO A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINO
Middle Name:A
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5397
Mailing Address - Street 2:CUC STATION
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-5397
Mailing Address - Country:US
Mailing Address - Phone:787-614-2694
Mailing Address - Fax:787-716-0946
Practice Address - Street 1:AVE BAIROA SANTA MARIA M3 ST
Practice Address - Street 2:# 1
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-948-7610
Practice Address - Fax:787-716-0946
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2256103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical