Healthcare Provider Details

I. General information

NPI: 1851657423
Provider Name (Legal Business Name): ANABEL SOTO-CARDALDA LND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2012
Last Update Date: 04/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 8 BOX 51500
HATILLO PR
00659-6115
US

IV. Provider business mailing address

HC 8 BOX 51500
HATILLO PR
00659-6115
US

V. Phone/Fax

Practice location:
  • Phone: 787-349-9935
  • Fax:
Mailing address:
  • Phone: 787-349-9935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number1313
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: