Individual
MS. MILDRED HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DIETICIAN
Contact information
Practice address
1715 AVE PONCE DE LEON, NUTRITION DEPT., SAN JUAN, PR 00909-1958
(787) 758-2000
(787) 771-7951
Mailing address
1471 CALLE HUMACAO, STOP 20, SAN JUAN, PR 00909-2633
(787) 722-4564
(787) 771-7951
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
645
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
645
DIETICIAN'S LICENSE
PR
Enumeration date
04/03/2007
Last updated
07/08/2007
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