Provider Demographics
NPI:1518584572
Name:TORRES TAVAREZ, YARIMAR (LND)
Entity Type:Individual
Prefix:MISS
First Name:YARIMAR
Middle Name:
Last Name:TORRES TAVAREZ
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:URB. TOA ALTA HEIGHTS
Mailing Address - Street 2:C19 P-1
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-4242
Mailing Address - Country:US
Mailing Address - Phone:787-341-9520
Mailing Address - Fax:
Practice Address - Street 1:CARR 840, BO CERRO GORDO, SECTOR LA ALDEA
Practice Address - Street 2:ESPACIO 4B
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4405
Practice Address - Country:US
Practice Address - Phone:787-998-3141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
PR1534133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133N00000XDietary & Nutritional Service ProvidersNutritionist