Individual
MRS. IDALIA BURGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LND
Contact information
Practice address
1017 CALLE GEN DEL VALLE, URB LAS DELICIAS, SAN JUAN, PR 00924-3722
(787) 376-4116
Mailing address
B40 CALLE 2, URB.PASEO LAS VISTAS, SAN JUAN, PR 00926-5951
(787) 376-4116
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
114
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3264
AMERICAN HEALTH
PR
01
—
50338
PMC
PR
01
—
9240091
HUMANA HEALTH PLAN
PR
01
—
NUT 005
PHP
PR
Enumeration date
01/22/2007
Last updated
07/08/2007
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