Provider Demographics
NPI:1730143918
Name:FERNANDEZ, LYDIA R (MD)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:R
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:C-64 DIAMANTE
Mailing Address - Street 2:GOLDEN GATE CAPARRA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:787-385-8088
Mailing Address - Fax:787-296-2409
Practice Address - Street 1:HOSPITAL DE PSIQUIATRIA DR RAMON FERNANDEZ MARINA
Practice Address - Street 2:CALLE CASI BO MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922-2100
Practice Address - Country:US
Practice Address - Phone:787-296-2409
Practice Address - Fax:787-296-2409
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR70232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry