Provider Demographics
NPI:1700178852
Name:CASANOVA, HECTOR LUIS (MD,FACOG, FACS)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:LUIS
Last Name:CASANOVA
Suffix:
Gender:M
Credentials:MD,FACOG, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CARR 102 # KM
Mailing Address - Street 2:BO JOYUDAS
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-3100
Mailing Address - Country:US
Mailing Address - Phone:787-851-3513
Mailing Address - Fax:
Practice Address - Street 1:4 CARR 102 # KM
Practice Address - Street 2:BO JOYUDAS
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-3100
Practice Address - Country:US
Practice Address - Phone:787-367-5771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4177207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR004177OtherTEM, PHYSICIAN EXAMINATOR TRIBUNAL