Provider Demographics
NPI:1831765106
Name:PIZARRO, YEIZA (LCDA)
Entity type:Individual
Prefix:MS
First Name:YEIZA
Middle Name:
Last Name:PIZARRO
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 CALLE CORAL
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-1405
Mailing Address - Country:US
Mailing Address - Phone:787-903-4286
Mailing Address - Fax:
Practice Address - Street 1:1042 CALLE CORAL
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-1405
Practice Address - Country:US
Practice Address - Phone:787-903-4286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1461133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1461OtherDEPARTMENT OF HEALTH REGISTRATION