Provider Demographics
NPI:1568648012
Name:PINA ALVAREZ, LISANDRA (LND, RD,)
Entity Type:Individual
Prefix:MS
First Name:LISANDRA
Middle Name:
Last Name:PINA ALVAREZ
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 1:233 CALLE CARMO
Mailing Address - Street 2:URB. PASEO DEL SOL
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4669
Mailing Address - Country:US
Mailing Address - Phone:787-278-1738
Mailing Address - Fax:
Practice Address - Street 1:233 CALLE CARMO
Practice Address - Street 2:URB. PASEO DEL SOL
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4669
Practice Address - Country:US
Practice Address - Phone:787-278-1738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1117133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered