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General NPI Number Information
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NPI Number | 1003789355
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Entity Type | Organization
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Legal Business Name | INTERVENCION NUTRICIONAL LLC
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 359 CALLE SAN CLAUDIO SUITE 205 CUPEY PROFESIONAL MALL
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City | SAN JUAN
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State | PR
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Zip | 00926-9907
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Country | US
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Telephone | 787-308-1100
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Fax |
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Provider Business Mailing Address
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Address Line | HC 5 BOX 5373
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City | GUAYNABO
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State | PR
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Zip | 00971
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Country | US
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Telephone | 787-308-1100
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DOELYS HERNANDEZ
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Credential | LND
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Telephone | 787-308-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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