Provider Demographics
NPI:1881640209
Name:HERNANDEZ, LUIS ORLANDO (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ORLANDO
Last Name:HERNANDEZ
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 1:100 AVE LOS PATRIOTAS
Mailing Address - Street 2:CARR 129 KM 22.5 INT.
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-2301
Mailing Address - Country:US
Mailing Address - Phone:787-897-5752
Mailing Address - Fax:
Practice Address - Street 1:100 AVE LOS PATRIOTAS
Practice Address - Street 2:CARR 129 KM 22.5 INT.
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-2301
Practice Address - Country:US
Practice Address - Phone:787-897-5752
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9355208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR81410Medicare ID - Type Unspecified