Provider Demographics
NPI:1013730225
Name:MADRID-ALCALA, PERLA MARGARITA (RDN)
Entity type:Individual
Prefix:
First Name:PERLA
Middle Name:MARGARITA
Last Name:MADRID-ALCALA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 S ADAMS COUNTY PKWY
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-8222
Mailing Address - Country:US
Mailing Address - Phone:303-200-9200
Mailing Address - Fax:
Practice Address - Street 1:6791 HIGHWAY 2 LOT 87
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-2413
Practice Address - Country:US
Practice Address - Phone:720-345-7336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86298657133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered