Lellanes Justiz Hernandez
Physician Assistant, Medical in Ponce, PR. Individual provider (NPI-1).
NPI number1114756111
StatusActive
Last updated in NPPESJul 29, 2024
Details
- NPI
- 1114756111
- Entity type
- Individual (NPI-1)
- Name
- Lellanes Justiz Hernandez
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 29, 2024
- Certification date
- Jul 23, 2024
- Last updated
- Jul 29, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 000989 | PR | Yes |
Practice location
396 Calle Dr Luis F Sala Urb Industrial ReparadaPonce, PR 00716
Phone 787-840-2575
Mailing address
396 Calle Dr Luis Sala Urb Industrial ReparadaPonce, PR 00716
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