Organization
MUNICIPIO DE SAN JUAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EDIVETTE SOTO (NUTRITIONIST)
(787) 480-3000
Entity
Organization
Contact information
Practice address
1306 AVE FERNANDEZ JUNCOS, PARADA 19 SANTURCE, SAN JUAN, PR 00909-2521
(178) 748-0300
(787) 722-2220
Mailing address
1306 AVE FERNANDEZ JUNCOS, PDA 19 SANTURCE, SAN JUAN, PR 00909-2521
(787) 480-3000
(787) 722-2220
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
987
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
987
NUTRITION LICENCE NUMBER
PR
Enumeration date
10/11/2016
Last updated
10/11/2016
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