# FUNDACION PEDIATRICA DE DIABETES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184350449
- **Authorized official:** MRS. MARIANA BENITEZ (DIRECTORA EJECUTIVA)
- **Authorized official phone:** (787) 633-6310

## Contact information

- **Practice address:** 260 CALLE CONVENTO, 2 FLOOR, SAN JUAN, PR 00912
- **Practice address phone:** (787) 633-6373
- **Mailing address:** PO BOX 6453, SAN JUAN, PR 00914-6453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TH0004X | Health Psychologist | — | NULL | — |
| 103TH0004X | Health Psychologist | — | — | — |
| 103TS0200X | School Psychologist | — | NULL | — |
| 103TS0200X | School Psychologist | — | — | — |
| 133N00000X | Nutritionist | — | NULL | — |
| 133N00000X | Nutritionist | — | — | — |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | Yes |
| 133NN1002X | Nutrition Education Nutritionist | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2022
- **Last updated:** 09/09/2024