Provider Demographics
NPI:1720550833
Name:HERNANDEZ RODRIGUEZ, ALIVETTE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIVETTE
Middle Name:MARIE
Last Name:HERNANDEZ RODRIGUEZ
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:HC 2 BOX 32005
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-9482
Mailing Address - Country:US
Mailing Address - Phone:787-246-4834
Mailing Address - Fax:
Practice Address - Street 1:18 AVE SEVERIANO CUEVAS KM 141.1
Practice Address - Street 2:BO CAIMITAL BAJO
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-650-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-31
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22061208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice