Provider Demographics
NPI:1376311811
Name:ROMERO RODRIGUEZ, CAROLYNE YARET (RDN,LND,MHSN)
Entity Type:Individual
Prefix:
First Name:CAROLYNE
Middle Name:YARET
Last Name:ROMERO RODRIGUEZ
Suffix:
Gender:F
Credentials:RDN,LND,MHSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 URB BOSQUE DE LOS PINOS CALLE PALUSTRIS
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA JOBOS CARR 459 KM 11.4
Practice Address - Street 2:EDIFICIO PLAZA DEL MAR
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-473-9314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2214133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered