MEDICARE: PERLA MARGARITA MADRID-ALCALA RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	86298657	CO

General Provider Information

NPI Number	:	1013730225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PERLA MARGARITA MADRID-ALCALA RDN

Provider Business Mailing Address
First Line	:	4430 S ADAMS COUNTY PKWY
Second Line	:
City	:	BRIGHTON
State	:	CO
Zip	:	80601-8222
Country	:	US
Telephone Number	:	303-200-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	6791 HIGHWAY 2 LOT 87
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-2413
Country	:	US
Telephone Number	:	720-345-7336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2024
Last Update Date	:	11/05/2024

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