Healthcare Provider Details

I. General information

NPI: 1518584572
Provider Name (Legal Business Name): YARIMAR TORRES TAVAREZ LND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 840, BO CERRO GORDO, SECTOR LA ALDEA ESPACIO 4B
BAYAMON PR
00956-4405
US

IV. Provider business mailing address

URB. TOA ALTA HEIGHTS C19 P-1
TOA ALTA PR
00953-4242
US

V. Phone/Fax

Practice location:
  • Phone: 939-787-0526
  • Fax:
Mailing address:
  • Phone: 787-341-9520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number1534
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: