Provider Demographics
NPI:1952125049
Name:HERNANDEZ HERNANDEZ, KRISTEAN XIOMAR (AUD)
Entity type:Individual
Prefix:DR
First Name:KRISTEAN
Middle Name:XIOMAR
Last Name:HERNANDEZ HERNANDEZ
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 8357
Mailing Address - Street 2:
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720-9466
Mailing Address - Country:US
Mailing Address - Phone:787-487-6633
Mailing Address - Fax:
Practice Address - Street 1:MANATI AUDIOLOGY AND BALANCE CENTER
Practice Address - Street 2:MMC PROFESSIONAL PLAZA SUITE 302
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-607-6461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1040231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist