Provider Demographics
NPI:1659042323
Name:NUTRICION PARA TODOS PSC
Entity Type:Organization
Organization Name:NUTRICION PARA TODOS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRUCIONISTA
Authorized Official - Prefix:
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCDA
Authorized Official - Phone:787-364-0423
Mailing Address - Street 1:CALLE 15 SE NUM 990 REPARTO METROPOLITANO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-9998
Mailing Address - Country:US
Mailing Address - Phone:787-364-0423
Mailing Address - Fax:
Practice Address - Street 1:CARR 831 KM 4 7 MINILLAS
Practice Address - Street 2:CARR 831 KM 4 7 MINILLAS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-364-0423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR00555OtherNUTRITION