Provider Demographics
NPI:1467691972
Name:PEREZ, JOSELYN M (LND)
Entity Type:Individual
Prefix:MRS
First Name:JOSELYN
Middle Name:M
Last Name:PEREZ
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 83
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0083
Mailing Address - Country:US
Mailing Address - Phone:787-602-3610
Mailing Address - Fax:
Practice Address - Street 1:CALLE JAZMIN # 28
Practice Address - Street 2:LOS PAISAJES EN CIUDAD JARDIN
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-0000
Practice Address - Country:US
Practice Address - Phone:787-602-3610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-08
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1460133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education