Provider Demographics
NPI:1710596820
Name:VIEL TORRES, SARA (DIETICIAN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:VIEL TORRES
Suffix:
Gender:F
Credentials:DIETICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CALLE MANUEL F ROSSY
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-4311
Mailing Address - Country:US
Mailing Address - Phone:787-645-4683
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA PONCE DE LEON 715
Practice Address - Street 2:NUTRITION DEPARTMENT
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-645-4683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR86054755133V00000X
PR2084133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2084OtherLND
PR86054755OtherRD