Healthcare Provider Details

I. General information

NPI: 1316696677
Provider Name (Legal Business Name): GENESIS ALMONTE I RDN, LND, MHSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 08/09/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 AVE PONCE DE LEON
HATO REY PR
00917-5032
US

IV. Provider business mailing address

1 LOS CANTIZALES APT 3L
SAN JUAN PR
00926-2598
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2000
  • Fax:
Mailing address:
  • Phone: 787-463-9249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number2181
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2181
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: