Individual
OMAR CANDELARIO VALDIVIESO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LND
Contact information
Practice address
URB. GUAYAMA VALLEY STREET 15 H-11, GUAYAMA, PR 00785
(787) 204-1036
Mailing address
PO BOX 3325, GUAYAMA, PR 00785-3325
(787) 204-1036
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
2060
PR
Other
Enumeration date
04/17/2020
Last updated
04/17/2020
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