Individual provider Active NPI

Janice Rodriguez Hernandez, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Guaynabo, PR
National Provider Identifier
1104266006
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
19689 Issued in PR
Practice address
Maramar Plaza 1270
101 Ave San Patricio
Guaynabo, PR 00968
Phone
(787) 751-2509
Fax
(787) 781-5307
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 19689 PR Primary

Addresses

Primary practice location

Maramar Plaza 1270
101 Ave San Patricio
Guaynabo, PR 00968

Mailing address

675 Calle Sergio Cuevas
Cond Torre del Cardenal Apto 601 Box 33
San Juan, PR 00918
Phone (787) 751-2509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200921000220 GA Order and Referring Only - NeurologyPractitioner - Neurology 7719305952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19689PRMDNeurology with Special Qualifications in Child Neurology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1104266006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 CALLE SERGIO CUEVAS",
            "address_2": "COND TORRE DEL CARDENAL APTO 601 BOX 33",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-751-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARAMAR PLAZA 1270",
            "address_2": "101 AVE SAN PATRICIO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968",
            "telephone_number": "787-751-2509",
            "fax_number": "787-781-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ HERNANDEZ",
        "first_name": "JANICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "PR",
            "license": "19689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.