Organization
NUTRIVIDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSELYN M PEREZ RDN (OFFICER)
(939) 652-7601
Entity
Organization
Contact information
Practice address
53 CALLE DR GOYCO, CAGUAS, PR 00725-2624
(787) 652-7601
Mailing address
28 CALLE URANO LOS PAISAJES CIUDAD JARDIN, GURABO, PR 00778-9211
(939) 652-7601
Taxonomy
Speciality
Code
Description
License number
State
133VN1301X
Oncology Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467691972
DIETITIAN
PR
05
—
1467691972
—
PR
Enumeration date
02/20/2022
Last updated
04/07/2024
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