Provider Demographics
NPI:1396466413
Name:HERNANDEZ MARRERO, PABLO ELIAS (MD)
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:ELIAS
Last Name:HERNANDEZ MARRERO
Suffix:
Gender:M
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:URB ALTURAS DE MAYAGUEZ
Mailing Address - Street 2:402 ALMIRANTE
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-458-9987
Mailing Address - Fax:
Practice Address - Street 1:AVE. UNIVERSIDAD INTERAMERICANA SAN GERMAN
Practice Address - Street 2:122-B
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-366-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR022977208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice