Provider Demographics
NPI:1821812017
Name:PERALES, VIANGELY P (RDN, LND, MHSN)
Entity type:Individual
Prefix:
First Name:VIANGELY
Middle Name:P
Last Name:PERALES
Suffix:
Gender:
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:URB. ATENAS
Mailing Address - Street 2:CALLE HERNANDEZ CARRION 68
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-621-3700
Mailing Address - Fax:
Practice Address - Street 1:URB. ATENAS
Practice Address - Street 2:CALLE HERNANDEZ CARRION 68
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2277133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered