Provider Demographics
NPI:1932393733
Name:DEL VALLE BELTRAN, EVELYN (LND)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:DEL VALLE BELTRAN
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:P.O.BOX 531
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00771
Mailing Address - Country:UM
Mailing Address - Phone:787-249-5011
Mailing Address - Fax:787-733-2640
Practice Address - Street 1:URB.PARKHURST LOCAL # 4
Practice Address - Street 2:
Practice Address - City:LAS PIEDRAS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00771
Practice Address - Country:UM
Practice Address - Phone:787-733-2640
Practice Address - Fax:787-733-2640
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR958133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist