Provider Demographics
NPI:1023824356
Name:HERNANDEZ BEAUCHAMP, GABRIELA A (ND)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:A
Last Name:HERNANDEZ BEAUCHAMP
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:PO BOX 6451
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6451
Mailing Address - Country:US
Mailing Address - Phone:787-322-7994
Mailing Address - Fax:
Practice Address - Street 1:I12 CALLE WILSON
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1357
Practice Address - Country:US
Practice Address - Phone:787-322-7994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
PR106175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer