| Clinica Nutricion Cdt G.m.s.p., Inc | |
|
B7 Calle Santa Cruz Bayamon PR 00961-6902 | |
| (787) 780-9196 | |
| Not Available |
| Full Name | Clinica Nutricion Cdt G.m.s.p., Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | B7 Calle Santa Cruz, Bayamon, Puerto Rico |
| Authorized Official Name and Position | Ilia Zayas (EXCUTIVE DIRECTOR) |
| Authorized Official Contact | 7877809196 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Nutricion Cdt G.m.s.p., Inc B7 Calle Santa Cruz Bayamon PR 00961-6902 Ph: () - | Clinica Nutricion Cdt G.m.s.p., Inc B7 Calle Santa Cruz Bayamon PR 00961-6902 Ph: (787) 780-9196 |
| NPI Number | 1912341884 |
|---|---|
| Provider Enumeration Date | 04/23/2013 |
| Last Update Date | 06/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912341884 | NPI | - | NPPES |
| 037582600 | Medicaid | PR | |
| FL377A | Other | FIRST COAST PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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