Provider Demographics
NPI:1801106182
Name:HERNANDEZ-PASTRANA, MONICA (MD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:HERNANDEZ-PASTRANA
Suffix:
Gender:F
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:BOSQUE DEL LAGO BC-36 PLAZA9
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00976
Mailing Address - Country:UM
Mailing Address - Phone:787-402-1712
Mailing Address - Fax:
Practice Address - Street 1:CALLE CARITE #130 LAGO ALTO
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00976
Practice Address - Country:UM
Practice Address - Phone:787-292-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18076208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice