Healthcare Provider Details

I. General information

NPI: 1114090990
Provider Name (Legal Business Name): WALESKA E APONTE-SLIVA LND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1681 PASEO VILLA FLORES SUITE 202
PONCE PR
00716-2952
US

IV. Provider business mailing address

PO BOX 335567
PONCE PR
00733-5567
US

V. Phone/Fax

Practice location:
  • Phone: 787-284-2221
  • Fax: 787-284-2015
Mailing address:
  • Phone: 787-284-2221
  • Fax: 787-284-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number914
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: