Healthcare Provider Details

I. General information

NPI: 1053424309
Provider Name (Legal Business Name): OLGA N AGRONT LND, DE, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 06/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONDOMINIO TORRE DE LOS FRAILES 2080 APT,10-A
GUAYNABO PR
00966
US

IV. Provider business mailing address

CONDOMINIO TORRE DE LOS FRAILES 2080 APT,10-A
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 787-309-5723
  • Fax:
Mailing address:
  • Phone: 787-309-5723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number1370
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: