Provider Demographics
NPI:1235338161
Name:RADA, BEATRIZ E (ND)
Entity Type:Individual
Prefix:MISS
First Name:BEATRIZ
Middle Name:E
Last Name:RADA
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:A18 CALLE 15A
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-5842
Mailing Address - Country:US
Mailing Address - Phone:787-319-6106
Mailing Address - Fax:
Practice Address - Street 1:A18 CALLE 15A
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-5842
Practice Address - Country:US
Practice Address - Phone:787-319-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1334133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered