Healthcare Provider Details

I. General information

NPI: 1750070868
Provider Name (Legal Business Name): DEVIN JOEL TORRES NIEVES I RDN, LND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 CALLE ANASCO APT 2106
SAN JUAN PR
00925-2476
US

IV. Provider business mailing address

839 CALLE ANASCO APT 2106
SAN JUAN PR
00925-2476
US

V. Phone/Fax

Practice location:
  • Phone: 787-453-9454
  • Fax:
Mailing address:
  • Phone: 787-453-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number2195
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: