Provider Demographics
NPI:1134691751
Name:SANTOS OCASIO, KARLA MICHELLE (RDN, LND, MHSN)
Entity type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:MICHELLE
Last Name:SANTOS OCASIO
Suffix:
Gender:F
Credentials:RDN, LND, MHSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 CARR 837 COND GRAND VIEW
Mailing Address - Street 2:APT 409
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971
Mailing Address - Country:US
Mailing Address - Phone:787-504-2069
Mailing Address - Fax:
Practice Address - Street 1:455 CARR 837 COND GRAND VIEW
Practice Address - Street 2:APT 409
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00971-9643
Practice Address - Country:US
Practice Address - Phone:787-504-2069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR86089079133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered