Provider Demographics
NPI:1083946982
Name:BORRERO-WALKER, JUDITH (RD LND)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:BORRERO-WALKER
Suffix:
Gender:F
Credentials:RD LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE I B/I #26
Mailing Address - Street 2:
Mailing Address - City:JARDINES DE CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-615-8976
Mailing Address - Fax:
Practice Address - Street 1:AVE. GENERAL-VALERO KM 2.6 CARR 194 BLD. 404
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-655-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1111133V00000X
TX726334133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered