Provider Demographics
NPI:1538891775
Name:HERNANDEZ, DAVID JOSE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSE
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 ARQ. PEDRO A. BIGAY
Mailing Address - Street 2:URB. BALDRICH
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-4024
Mailing Address - Country:US
Mailing Address - Phone:787-543-9696
Mailing Address - Fax:
Practice Address - Street 1:GUILLERMO ESTEVES 63
Practice Address - Street 2:
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664
Practice Address - Country:US
Practice Address - Phone:787-828-4265
Practice Address - Fax:787-828-0279
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty