Provider Demographics
NPI:1508293812
Name:CLEMENTE, ZUANIA Y (DIETITIAN)
Entity Type:Individual
Prefix:MS
First Name:ZUANIA
Middle Name:Y
Last Name:CLEMENTE
Suffix:
Gender:F
Credentials:DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 CALLE CARMEN BUZELLO
Mailing Address - Street 2:COUNTRY CLUB SECOND EXTENSION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-2429
Mailing Address - Country:US
Mailing Address - Phone:787-646-4032
Mailing Address - Fax:
Practice Address - Street 1:715 AVE PONCE DE LEON
Practice Address - Street 2:NUTRITION DEPARTMENT
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5032
Practice Address - Country:US
Practice Address - Phone:787-758-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1632133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1632OtherDIETITIAN'S LICENSE