Provider Demographics
NPI:1649205709
Name:REYES-HERNANDEZ, TAMARI (MD)
Entity Type:Individual
Prefix:
First Name:TAMARI
Middle Name:
Last Name:REYES-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 1:921 CALLE TORRECILLAS
Mailing Address - Street 2:ALTURAS DE MAYAGUEZ
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6223
Mailing Address - Country:US
Mailing Address - Phone:787-429-1532
Mailing Address - Fax:787-805-0177
Practice Address - Street 1:921 CALLE TORRECILLAS
Practice Address - Street 2:ALTURAS DE MAYAGUEZ
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6223
Practice Address - Country:US
Practice Address - Phone:787-429-1532
Practice Address - Fax:787-805-0177
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9591208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG37152Medicare UPIN
PR8-8683Medicare ID - Type UnspecifiedGENERAL MEDICINNE