Provider Demographics
NPI:1720407760
Name:ROSARIO, YARILIS (LND)
Entity Type:Individual
Prefix:
First Name:YARILIS
Middle Name:
Last Name:ROSARIO
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:HC 1 BOX 5800
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-9534
Mailing Address - Country:US
Mailing Address - Phone:787-367-5438
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 5800
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-9534
Practice Address - Country:US
Practice Address - Phone:787-367-5438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1607133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education