Provider Demographics
NPI:1265268999
Name:HERNANDEZ, TOMAS JAVIER SR
Entity type:Individual
Prefix:
First Name:TOMAS
Middle Name:JAVIER
Last Name:HERNANDEZ
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 607071
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-7071
Mailing Address - Country:US
Mailing Address - Phone:787-410-2008
Mailing Address - Fax:
Practice Address - Street 1:MANUEL F. ROSSY, ESQ. ISABEL II
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-410-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR029404163WC0200X, 163WC0400X, 163WG0000X, 163WH0200X, 163WH1000X, 163WI0500X, 163WM1400X, 163WN1003X, 163WP0809X, 163WR0400X, 364SC1501X
251J00000X, 261QA0600X, 261QE0002X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No251J00000XAgenciesNursing Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant