Provider Demographics
NPI:1104016047
Name:ALVARADO, SANDRA E (RD,LND)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:ALVARADO
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:PARQUE EL SENORIAL
Mailing Address - Street 2:2042 BENITO FEIJOO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6601
Mailing Address - Country:US
Mailing Address - Phone:787-760-8462
Mailing Address - Fax:
Practice Address - Street 1:759 AVE AVELINO VICENTE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2615
Practice Address - Country:US
Practice Address - Phone:787-724-5559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1088133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist