Provider Demographics
NPI:1922326917
Name:HERNANDEZ, SULEIMA JUDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:SULEIMA
Middle Name:JUDITH
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SULEIMA
Other - Middle Name:JUDITH
Other - Last Name:HERNANDEZ JIMENEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:155 CALLE FARO
Mailing Address - Street 2:URBANIZACION ALTURAS DEL MAR
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-5603
Mailing Address - Country:US
Mailing Address - Phone:787-232-5396
Mailing Address - Fax:
Practice Address - Street 1:155 CALLE FARO
Practice Address - Street 2:URBANIZACION ALTURAS DEL MAR
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-5603
Practice Address - Country:US
Practice Address - Phone:787-232-5396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17920208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice