Provider Demographics
NPI:1447568159
Name:PRESTAMO-TORRES, ZAYRA M (LND, RD)
Entity Type:Individual
Prefix:
First Name:ZAYRA
Middle Name:M
Last Name:PRESTAMO-TORRES
Suffix:
Gender:F
Credentials:LND, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ANDREA'S COURT 370 CALLE 10
Mailing Address - Street 2:APT 105
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-7818
Mailing Address - Country:US
Mailing Address - Phone:787-691-2895
Mailing Address - Fax:
Practice Address - Street 1:1607 AVE PONCE DE LEON
Practice Address - Street 2:COBIANS PLAZA GM-4
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1820
Practice Address - Country:US
Practice Address - Phone:787-998-0493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1063133N00000X
PR811258133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered