Provider Demographics
NPI:1972912103
Name:HERNANDEZ, RICARDO JAVIER (PHARM D)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:JAVIER
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 E WEST HWY STE 1200
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-5003
Mailing Address - Country:US
Mailing Address - Phone:301-955-0005
Mailing Address - Fax:
Practice Address - Street 1:3500 E WEST HWY STE 1200
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-5003
Practice Address - Country:US
Practice Address - Phone:301-955-0005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist