Provider Demographics
NPI:1750270047
Name:FERNANDEZ HERNANDEZ, ALANIS GABRIELA
Entity type:Individual
Prefix:
First Name:ALANIS
Middle Name:GABRIELA
Last Name:FERNANDEZ HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. LAS CASCADAS 1450
Mailing Address - Street 2:CALLE AGUAS TIBIAS AE-18
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-3204
Mailing Address - Country:US
Mailing Address - Phone:787-470-9166
Mailing Address - Fax:
Practice Address - Street 1:WALGREENS DORAMAR PLAZA
Practice Address - Street 2:7006 PR-693, DORADO, 00646
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-278-5812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2527390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program