Healthcare Provider Details
I. General information
NPI: 1780877506
Provider Name (Legal Business Name): NUTRITION METABOLISM EDUCATION AND TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2007
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
PARRA MEDICAL INSTITUTE SUITE 509, 2225 PONCE BY PASS
PONCE PR
00717-1382
US
IV. Provider business mailing address
PARRA MEDICAL INSTITUTE SUITE 509, 2225 PONCE BY PASS
PONCE PR
00717-1382
US
V. Phone/Fax
- Phone: 787-284-7150
- Fax: 787-842-1199
- Phone: 787-284-7150
- Fax: 787-842-1199
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | 1380 |
| License Number State | PR |
VIII. Authorized Official
Name: MRS.
ELINES
FRANCO
Title or Position: DIETITIAN
Credential: DIETITIAN, DE, CLE
Phone: 787-284-7150