Individual
MRS. LYDMARIE OLIVERAS HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LND
Contact information
Practice address
B11 CALLE SANTA CRUZ, BAYAMON, PR 00961-6902
(787) 314-6825
Mailing address
PO BOX 2218, VEGA BAJA, PR 00694-2218
(787) 532-8785
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1973
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5260
MCS
PR
05
—
5260
—
PR
Enumeration date
04/11/2019
Last updated
08/19/2019
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