Individual
JOHANNIE GONZALEZ VELAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDA
Contact information
Practice address
536 AVE VICTORIA, AGUADILLA, PR 00603-4623
(787) 658-6218
(787) 658-7116
Mailing address
HC 2 BOX 11671, MOCA, PR 00676-8255
(787) 617-7144
(787) 658-7116
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
1471
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1471
NUTRITIONIST / DIETIST
PR
Enumeration date
12/03/2019
Last updated
12/03/2019
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