Healthcare Provider Details

I. General information

NPI: 1164558169
Provider Name (Legal Business Name): ZENAIDA RIOS L.N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR CAR 107 21 SEVERIANO CUEVAS
AGUADILLA PR
00603
US

IV. Provider business mailing address

PR CARR107 6 REPARTO BELLAFLORES
AGUADILLA PR
00603
US

V. Phone/Fax

Practice location:
  • Phone: 787-882-5660
  • Fax: 787-882-5665
Mailing address:
  • Phone: 787-882-5660
  • Fax: 787-882-5665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number0189
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: