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NPI Code Detail

MEDICARE: LILIANA ELIZABETH BONILLA HERNANDEZ FNP-BC

MEDICARE: LILIANA ELIZABETH BONILLA HERNANDEZ FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024196102VA

General Provider Information

NPI Number : 1912857947
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILIANA ELIZABETH BONILLA HERNANDEZ FNP-BC
Provider Business Mailing Address
First Line : 1939 ROLAND CLARKE PL STE 200
Second Line :
City : RESTON
State : VA
Zip : 20191-1445
Country : US
Telephone Number : 703-435-3366
Fax Number : 703-782-8833
Provider Business Practice Location Address
First Line : 1939 ROLAND CLARKE PL STE 200
Second Line :
City : RESTON
State : VA
Zip : 20191-1445
Country : US
Telephone Number : 703-435-3366
Fax Number : 703-782-8833
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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Directions to “ LILIANA ELIZABETH BONILLA HERNANDEZ FNP-BC” Practice Location

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