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Organization

WELLNESS AT EDP LLC

Active
Other names
Wellness @ EDP LLC
Organization subpart
No

Provider details

NPI number
Authorized official
GLADYS TERESA NIEVES VAZQUEZ ING (MEMBER)
(787) 765-3560
Entity
Organization

Contact information

Practice address
AVE PONCE DE LEON 560 HATO REY, SAN JUAN, PR 00918
(787) 765-3560
Mailing address
PO BOX 192303, SAN JUAN, PR 00919-2303

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
171400000X
Health & Wellness Coach
Primary
174H00000X
Health Educator
175F00000X
Naturopath
2083P0901X
Public Health & General Preventive Medicine Physician
2251G0304X
Geriatric Physical Therapist
225700000X
Massage Therapist
225800000X
Recreation Therapist
363LC1500X
Community Health Nurse Practitioner

Other

Enumeration date
10/12/2021
Last updated
08/21/2023
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