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Individual

IVELISSE ALVERIO SANTANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LND

Contact information

Practice address
HF16 CALLE LIZZIE GRAHAM, TOA BAJA, PR 00949-3634
(787) 309-6283
Mailing address
PO BOX 56144, BAYAMON, PR 00960-6144
(787) 309-6283

Taxonomy

Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
1472
PR

Other

Enumeration date
02/03/2009
Last updated
12/21/2018
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