Organization
NUTREVITA CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA SANTIAGO GORDIAN RDN, LND, CDCES (DIRECTOR)
(787) 550-2510
Entity
Organization
Contact information
Practice address
CALLE GARCIA DE LA NOCEDA B26, VILLAS DE RIO GRANDE, RIO GRANDE, PR 00745
(787) 550-2510
Mailing address
17166 GOOSEN DR, CANOVANAS, PR 00729-4508
(787) 552-2510
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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