Provider Demographics
NPI:1952729063
Name:HERNANDEZ, LIZBETH (PHL)
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. MONTE ATENAS APTO. 701
Mailing Address - Street 2:CALLE ATENAS 1300
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00926
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COND. MONTE ATENAS APTO. 701
Practice Address - Street 2:CALLE ATENAS 1300
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00926
Practice Address - Country:UM
Practice Address - Phone:787-525-5342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist