Provider Demographics
NPI:1811108038
Name:PIZARRO, CARMEN ROSA (LND)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:ROSA
Last Name:PIZARRO
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 361647
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1647
Mailing Address - Country:US
Mailing Address - Phone:787-397-6446
Mailing Address - Fax:
Practice Address - Street 1:150 CARR 873
Practice Address - Street 2:77 BOX VISTAS DE LOS FRAILES
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5152
Practice Address - Country:US
Practice Address - Phone:787-397-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1307132700000X, 133N00000X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No133N00000XDietary & Nutritional Service ProvidersNutritionist