Healthcare Provider Details

I. General information

NPI: 1295933562
Provider Name (Legal Business Name): NUTRITION METABOLISM EDUCATION AND TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PARRA MEDICAL INSTITUTE SUITE 509 PONCE BYPASS
PONCE PR
00717-1382
US

IV. Provider business mailing address

PARRA MEDICAL INSTITUTE SUITE 509 2225 PONCE BYPASS
PONCE PR
00717-1382
US

V. Phone/Fax

Practice location:
  • Phone: 787-284-7150
  • Fax: 787-842-1199
Mailing address:
  • Phone: 787-284-7150
  • Fax: 787-842-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1380
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number689
License Number StatePR

VIII. Authorized Official

Name: MS. BETSY Y RODRIGUEZ
Title or Position: ADMINISTRATIVE ASSISTANT
Credential: DIETITIAN DE CPT
Phone: 787-284-7150