Provider Demographics
NPI:1053375501
Name:HERRERA CESPEDES, HUMBERTO (MD)
Entity type:Individual
Prefix:
First Name:HUMBERTO
Middle Name:
Last Name:HERRERA CESPEDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8908
Mailing Address - Street 2:PLAZA CAROLINA STATION,
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-8908
Mailing Address - Country:US
Mailing Address - Phone:787-276-1743
Mailing Address - Fax:787-283-1356
Practice Address - Street 1:GP8 AVE ROBERTO SANCHEZ VILELLA
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2677
Practice Address - Country:US
Practice Address - Phone:787-276-1743
Practice Address - Fax:787-283-1356
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10270208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF72388Medicare UPIN
PRCY452AMedicare PIN
PR0083966AMedicare PIN