Healthcare Provider Details

I. General information

NPI: 1366175648
Provider Name (Legal Business Name): NUTRE CON NUTRI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 07/05/2022
Certification Date: 06/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2-6 MUNOZ RIVERA FERRER ST
GUAYNABO PR
00969
US

IV. Provider business mailing address

URB CASTELLANA GARDENS C 14 K 12
CAROLINA PR
00983
US

V. Phone/Fax

Practice location:
  • Phone: 787-205-1607
  • Fax:
Mailing address:
  • Phone: 787-398-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: KEYLA M ORTIZ ARROYO
Title or Position: SOLE MEMBER
Credential: LCDA
Phone: 787-398-3777