Healthcare Provider Details

I. General information

NPI: 1932908068
Provider Name (Legal Business Name): ZAMELY MARIE MILLAN LND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 CALLE DR VEVE APT 1622
BAYAMON PR
00961-6143
US

IV. Provider business mailing address

124 CALLE DR VEVE APT 1622
BAYAMON PR
00961-6143
US

V. Phone/Fax

Practice location:
  • Phone: 787-593-5293
  • Fax:
Mailing address:
  • Phone: 787-593-5293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number2282
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number1030
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number2282
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: