Provider Demographics
NPI:1710620133
Name:HERNANDEZ GARCIA, KARELYN ANDREA
Entity Type:Individual
Prefix:
First Name:KARELYN
Middle Name:ANDREA
Last Name:HERNANDEZ GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 13918
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-9519
Mailing Address - Country:US
Mailing Address - Phone:787-341-4395
Mailing Address - Fax:
Practice Address - Street 1:CARR. 149 BO GUAYABAL KM 62.2
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-341-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty