Provider Demographics
NPI:1952182529
Name:TAMAYO BAYAS, MILICEN CAMILA (MPH, RDN)
Entity type:Individual
Prefix:
First Name:MILICEN
Middle Name:CAMILA
Last Name:TAMAYO BAYAS
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ELIZABETH ST APT G7
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-3270
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NUMA POMPILIO LLONA S-N, BUILDING SPAZIO DEPARTMENT 703
Practice Address - Street 2:
Practice Address - City:GUAYAQUIL
Practice Address - State:GUAYAS
Practice Address - Zip Code:090110
Practice Address - Country:EC
Practice Address - Phone:000-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL007590133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered