Provider Demographics
NPI:1275558512
Name:ALVARADO QUINONES, NYDIA ESTHER (LND)
Entity Type:Individual
Prefix:MRS
First Name:NYDIA
Middle Name:ESTHER
Last Name:ALVARADO QUINONES
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:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-0308
Mailing Address - Country:US
Mailing Address - Phone:787-836-4008
Mailing Address - Fax:
Practice Address - Street 1:13A CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3654
Practice Address - Country:US
Practice Address - Phone:787-689-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR624133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0053573Medicare ID - Type UnspecifiedPROVIDER NUMBER