MEDICARE: MISS DOELYS HERNANDEZ LND

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	133NN1002X	Nutrition Education Nutritionist	1352	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1352	OTHER	PR	DIETITIAN LICENSE

General Provider Information

NPI Number	:	1770785909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DOELYS HERNANDEZ LND

Provider Business Mailing Address
First Line	:	HC 4 BOX 5373
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00971-9516
Country	:	US
Telephone Number	:	787-758-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	359 CALLE SAN CLAUDIO S
Second Line	:	SUITE 205 CUPEY PROFESSIONAL MALL
City	:	SAN JUAN
State	:	PR
Zip	:	00926-9907
Country	:	US
Telephone Number	:	787-308-1100
Fax Number	:

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

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	09/10/2025

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