Provider Demographics
NPI:1003789355
Name:INTERVENCION NUTRICIONAL LLC
Entity type:Organization
Organization Name:INTERVENCION NUTRICIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LND
Authorized Official - Phone:787-308-1100
Mailing Address - Street 1:HC 5 BOX 5373
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971
Mailing Address - Country:US
Mailing Address - Phone:787-308-1100
Mailing Address - Fax:
Practice Address - Street 1:359 CALLE SAN CLAUDIO
Practice Address - Street 2:SUITE 205 CUPEY PROFESIONAL MALL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9907
Practice Address - Country:US
Practice Address - Phone:787-308-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty