Provider Demographics
NPI:1982163770
Name:BIAGGI, LIZA MILAGROS (LND)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:MILAGROS
Last Name:BIAGGI
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 980
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-0980
Mailing Address - Country:US
Mailing Address - Phone:787-628-1627
Mailing Address - Fax:787-652-4865
Practice Address - Street 1:20 CALLE JADE
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-2068
Practice Address - Country:US
Practice Address - Phone:787-628-1627
Practice Address - Fax:787-652-4865
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2013133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist