Organization
CAREVIDA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CARRILLO RUSSE (NUTRITIONIST)
(787) 710-7109
Entity
Organization
Contact information
Practice address
452 AVE HOSTOS, SAN JUAN, PR 00918-3062
(787) 710-7109
Mailing address
CALLE SAN JOSE APT 806, FONTAINEBLEU VILLAGE, GUAYNABO, PR 00969
(787) 510-9452
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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