Healthcare Provider Details

I. General information

NPI: 1174280051
Provider Name (Legal Business Name): MISS VALERIA MARIA SANTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2021
Last Update Date: 04/11/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 CALLE DR GOYCO
CAGUAS PR
00725-2624
US

IV. Provider business mailing address

PMB 291 POBOX 4960
CAGUAS PR
00726
US

V. Phone/Fax

Practice location:
  • Phone: 787-379-2965
  • Fax:
Mailing address:
  • Phone: 787-379-2965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StatePR
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2187
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: