Most Relevant Information
Provider Data
| NPI Number: | 1003059353 |
| Provider Name: | MARY GRACE HERNANDEZ LASQUETY M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207Q00000X |
| Specialty: | Family Medicine |
| License Number: | 56635 |
Most Important Dates
| Enumeration Date: | 04/16/2009 |
| Last Updated: | 08/20/2015 |
Provider Practice Location
2311 N PROSPECT AVE
MILWAUKEE
WI
532114445
Practice Location Phone/Fax
| Phone: | 4143193000 |
| Fax: | 4143193033 |
Provider Mailing Location
4425 N PORT WASHINGTON RD
GLENDALE
WI
532121082
Provider Mailing Phone/Fax
| Phone: | 4143193000 |
| Fax: |
Suggested EMR
Family Practice EMR