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General NPI Number Information
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NPI Number | 1174023568
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Entity Type | Individual
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Provider Name | YAHAIRA AILEEN FELICIANO LND
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Gender | Female
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 02/13/2018
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Provider Practice Location Address
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Address Line | 1551 CALLE ALDA
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City | SAN JUAN
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State | PR
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Zip | 00926-2709
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Country | US
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Telephone | 787-356-2134
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 8515
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City | HATILLO
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State | PR
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Zip | 00659-7415
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Country | US
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Telephone | 787-356-2134
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 2030
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License Number State | PR
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