Active NPI
Ricardo Hernandez Jr.
- Medical Laboratory Technician
- Phoenix, AZ
National Provider Identifier
1902274145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Laboratory Technician
- License
- 25444944
- Practice address
- 3462 E Charleston Ave
Phoenix, AZ 85032-1219 - Phone
- (602) 810-1666
- NPI assigned
- Sep 4, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Laboratory Technician | 246RM2200X | 25444944 | AZ | Primary |
Addresses
Primary practice location
3462 E Charleston Ave
Phoenix, AZ 85032-1219
Mailing address
3462 E Charleston Ave
Phoenix, AZ 85032-1219
Phone (602) 810-1666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25444944 | AZ | MD | Medical Laboratory Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441324800000",
"number": "1902274145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3462 E CHARLESTON AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850321219",
"telephone_number": "602-810-1666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3462 E CHARLESTON AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850321219",
"telephone_number": "602-810-1666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "RICARDO",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-04",
"last_updated": "2015-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "246RM2200X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Medical Laboratory",
"state": "AZ",
"license": "25444944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.