Provider Demographics
NPI:1760093538
Name:FIGUEROA COLON, JEANNETTE (LND)
Entity Type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:
Last Name:FIGUEROA COLON
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:PO BOX 9122
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-9122
Mailing Address - Country:US
Mailing Address - Phone:787-501-8741
Mailing Address - Fax:787-850-5235
Practice Address - Street 1:201 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3310
Practice Address - Country:US
Practice Address - Phone:787-285-2395
Practice Address - Fax:787-850-2395
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1170133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist