Provider Demographics
NPI:1417254657
Name:NUTRITION, METABOLISM, EDUCATION AND TREATMENT
Entity Type:Organization
Organization Name:NUTRITION, METABOLISM, EDUCATION AND TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT N.M.E.T.C.
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRABANCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-841-7168
Mailing Address - Street 1:2225 PARRA MEDICAL INSTITUTE
Mailing Address - Street 2:SUITE 509 PONCE BY PASS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1382
Mailing Address - Country:US
Mailing Address - Phone:787-284-7150
Mailing Address - Fax:787-842-1199
Practice Address - Street 1:2225 PARRA MEDICAL INSTITUTE
Practice Address - Street 2:SUITE 509 PONCE BY PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1382
Practice Address - Country:US
Practice Address - Phone:787-284-7150
Practice Address - Fax:787-842-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084967Medicare PIN