MEDICARE: HANY MANUDIS HERNANDEZ BERNAL

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
1	163WH0200X	Home Health Registered Nurse	1213645	TX
2	163WI0500X	Infusion Therapy Registered Nurse	1213645	TX
3	163WN1003X	Nutrition Support Registered Nurse	1213645	TX
4	163WP2201X	Ambulatory Care Registered Nurse	1213645	TX
5	163W00000X	Registered Nurse	1213645	TX

General Provider Information

NPI Number	:	1306776703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANY MANUDIS HERNANDEZ BERNAL

Provider Business Mailing Address
First Line	:	21503 RAINFALL PARK DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-2645
Country	:	US
Telephone Number	:	561-507-3533
Fax Number	:	561-507-3533

Provider Business Practice Location Address
First Line	:	21503 RAINFALL PARK DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-2645
Country	:	US
Telephone Number	:	561-507-3533
Fax Number	:	561-507-3533

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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