Provider Demographics
NPI:1669508784
Name:FIGUEROA, CARMEN
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3159 CALLE CAFE
Mailing Address - Street 2:LOS CAOBOS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2742
Mailing Address - Country:US
Mailing Address - Phone:787-844-3002
Mailing Address - Fax:787-844-3002
Practice Address - Street 1:3159 CALLE CAFE
Practice Address - Street 2:LOS CAOBOS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2742
Practice Address - Country:US
Practice Address - Phone:787-844-3002
Practice Address - Fax:787-844-3002
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1122133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education