Provider Demographics
NPI:1710090964
Name:HERNANDEZ-CORDERO, SAVIER (PT)
Entity Type:Individual
Prefix:
First Name:SAVIER
Middle Name:
Last Name:HERNANDEZ-CORDERO
Suffix:
Gender:M
Credentials:PT
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 2598
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-2598
Mailing Address - Country:US
Mailing Address - Phone:787-922-1132
Mailing Address - Fax:787-877-5694
Practice Address - Street 1:CARR. 420 KM. 1.5 INT. BO. VOLADORAS MOCA
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-922-1132
Practice Address - Fax:787-877-5694
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRQ31550Medicare UPIN
PRQ31550Medicare UPIN