Provider Demographics
NPI:1164285003
Name:DELGADO, JANICE (LND)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 36938
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-9707
Mailing Address - Country:US
Mailing Address - Phone:787-226-0245
Mailing Address - Fax:
Practice Address - Street 1:TOMAS DE CASTRO 1
Practice Address - Street 2:CARR 761 KM 1.0
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-226-0245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2253133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered