Individual
WANDA I LLANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
CALLE AMERICO SALAS #1452 (ALTOS), PDA 22, SAN JUAN, PR 00910
(787) 640-5721
Mailing address
PO BOX 9108, SAN JUAN, PR 00908-0108
(787) 640-5721
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
1432
PR
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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