Healthcare Provider Details

I. General information

NPI: 1174445837
Provider Name (Legal Business Name): GENESIS MARIE HERNANDEZ REY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. VILLA BORINQUEN YAGUEZ ST J21
CAGUAS PR
00725
US

IV. Provider business mailing address

URB. VILLA BORINQUEN YAGUEZ ST J21
CAGUAS PR
00725
US

V. Phone/Fax

Practice location:
  • Phone: 787-226-9993
  • Fax:
Mailing address:
  • Phone: 787-226-9993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9520074
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6414
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: