Healthcare Provider Details

I. General information

NPI: 1427675487
Provider Name (Legal Business Name): CINDY M PEREZ COLON LND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 840 BARRIO CERRO GORDO SECTOR LA ALDEA ESPACIO 4B
BAYAMON PR
00956
US

IV. Provider business mailing address

URB FRANCISCO OLLER CALLE 6 Z3
BAYAMON PR
00956
US

V. Phone/Fax

Practice location:
  • Phone: 787-998-3141
  • Fax:
Mailing address:
  • Phone: 787-929-4479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number1525
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: