Provider Demographics
NPI:1144980061
Name:HERNANDEZ MARTINEZ, LEIDI P (ND)
Entity type:Individual
Prefix:DR
First Name:LEIDI
Middle Name:P
Last Name:HERNANDEZ MARTINEZ
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 BLVD LUIS A FERRE
Mailing Address - Street 2:EXT SAN ANTONIO
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-1818
Mailing Address - Country:US
Mailing Address - Phone:787-396-7286
Mailing Address - Fax:
Practice Address - Street 1:2431 BLVD LUIS A FERRE
Practice Address - Street 2:EDIF PORRATA PILA 208
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-451-6978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR80175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath