Provider Demographics
NPI:1669625364
Name:VERDEJO, JOYCE (LND)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:
Last Name:VERDEJO
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:UU22 CALLE YUNQUESITO
Mailing Address - Street 2:MANSIONES DE CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8125
Mailing Address - Country:US
Mailing Address - Phone:787-777-3535
Mailing Address - Fax:787-756-8907
Practice Address - Street 1:UU22 CALLE YUNQUESITO
Practice Address - Street 2:MANSIONES DE CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-8125
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-756-8907
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1319133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist