MEDICARE: HEIRA HERNANDEZ MEDINA LPC

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	101YP2500X	Professional Counselor	79724	TX
2	101YM0800X	Mental Health Counselor	MH25430	FL
3	101YP2500X	Professional Counselor	23824	AZ

General Provider Information

NPI Number	:	1710567045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIRA HERNANDEZ MEDINA LPC

Provider Business Mailing Address
First Line	:	L9 CALLE LOS ALMENDROS
Second Line	:
City	:	MERCEDITA
State	:	PR
Zip	:	00715-2035
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	COMUNIDAD PUNTA DIAMANTE
Second Line	:	CALLE NAIRA V-28
City	:	PONCE
State	:	PR
Zip	:	00728
Country	:	US
Telephone Number	:	820-400-0915
Fax Number	:

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

Provider Enumeration Date	:	04/12/2021
Last Update Date	:	02/18/2026

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