Provider Demographics
NPI:1467592725
Name:BONNET, MARITZA (RD,LND)
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:BONNET
Suffix:
Gender:F
Credentials:RD,LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PASEO REAL, CALLE ZAFIRO, D-52
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-366-9395
Mailing Address - Fax:787-796-0062
Practice Address - Street 1:PASEO REAL, CALLE ZAFIRO,
Practice Address - Street 2:D-52
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-366-9395
Practice Address - Fax:787-796-0062
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1407133N00000X
PR960815133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered