Individual
ALICIA Z DIAZ BOULON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LND, RD, MHSN, CDE
Contact information
Practice address
LA ALAMEDA, 785 CALLE RUBI, SAN JUAN, PR 00926-6733
(787) 422-0202
Mailing address
LA ALAMEDA, 785 CALLE RUBI, SAN JUAN, PR 00926-6733
(787) 422-0202
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
1239
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1239
LND
PR
01
—
2062-0127
CERT. DIABETES EDUCATOR
PR
01
—
867067
RD
PR
Enumeration date
06/05/2007
Last updated
10/09/2012
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