Provider Demographics
NPI:1780741538
Name:HERNANDEZ GARCIA, CESAR R (MD)
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:R
Last Name:HERNANDEZ GARCIA
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:HC 03 BOX 22217
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9300
Mailing Address - Country:US
Mailing Address - Phone:787-897-2816
Mailing Address - Fax:787-879-2816
Practice Address - Street 1:HC 03 BOX 22217
Practice Address - Street 2:CARR. 635, KM. 2.3
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-9300
Practice Address - Country:US
Practice Address - Phone:787-897-2816
Practice Address - Fax:787-879-2816
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3925207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3291-2Medicaid
PR3291-2Medicaid
PRE3-1140Medicare UPIN