Healthcare Provider Details

I. General information

NPI: 1831765106
Provider Name (Legal Business Name): YEIZA PIZARRO LCDA.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 CALLE CORAL
SALINAS PR
00751-1405
US

IV. Provider business mailing address

1042 CALLE CORAL
SALINAS PR
00751-1405
US

V. Phone/Fax

Practice location:
  • Phone: 787-903-4286
  • Fax:
Mailing address:
  • Phone: 787-903-4286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number1461
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: