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General NPI Number Information
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NPI Number | 1609406172
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Entity Type | Individual
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Provider Name | MARIELA MARIA HERNANDEZ RODRIGUEZ DC
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Gender | Female
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | AVE. ARTERIAL B #125 SUITE 103
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City | SAN JUAN
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State | PR
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Zip | 00911
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Country | US
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Telephone | 787-724-9797
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Fax |
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Provider Business Mailing Address
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Address Line | CAPARRA HEIGHTS CALLE ELMA 554
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City | SAN JUAN
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State | PR
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Zip | 00920
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Country | US
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Telephone | 787-421-2310
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14287
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License Number State | TX
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